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Leased Network Manager

Job description

The Leased Network Manager is responsible for the oversight, optimization, and maintenance of leased provider networks within a dental insurance organization. This role manages relationships with leased network vendors and providers, ensures compliance with state and federal regulations, and supports internal operations to meet business objectives. The Leased Network Manager collaborates cross-functionally to resolve provider issues, enhance network performance, and support strategic growth initiatives.


What You Will Do!

  • Manage relationships with leased network vendors and providers to ensure ongoing network quality, performance, and stability
  • Monitor network metrics including compliance training attestations, directory validation (DIV) compliance, and leased network error-load reports for assigned territory
  • Serve as a primary point of contact for escalated provider and vendor issues related to claims, directory updates, and service delivery
  • Partner with providers and internal teams to resolve disputes and ensure a positive experience for providers and members
  • Lead provider education efforts related to policies, procedures, and network updates
  • Ensure leased networks comply with all applicable state and federal regulations, including CMS requirements
  • Develop and maintain reporting tools to assess provider activity, network adequacy, and compliance performance
  • Collaborate with Provider Relations, Credentialing, Claims, Legal, and other internal teams to align on network initiatives
  • Support Sales and Client Services by addressing client-specific needs and delivering high-performing networks
  • Lead or contribute to special projects focused on network optimization, expansion, or regulatory compliance
  • Negotiate contract terms with leased network providers to optimize cost, access, and performance
  • Monitor vendor performance against service-level agreements (SLAs) and address operational gaps
  • Evaluate and recommend vendor changes or new partnerships based on strategic network needs
  • Support State and National Dental Directors with scheduling and counseling providers exhibiting aberrant utilization or billing patterns
  • Process facility changes and submit timely updates to internal systems
  • Complete monthly activity reports and provide project status updates as assigned
  • Perform other duties as assigned


What You Bring! 

Education

  • Bachelor’s degree in Healthcare Administration, Business, or a related field required
  • Equivalent combination of education and relevant experience may be considered

Experience

  • Minimum of 2 years in provider network management, provider relations, or vendor management within healthcare or insurance
  • Strong knowledge of provider network management and healthcare operations (dental insurance preferred)
  • Proven experience managing vendor relationships and negotiating contracts
  • Ability to analyze network adequacy and identify opportunities for improvement
  • Excellent communication and interpersonal skills to engage providers, vendors, and internal stakeholders
  • Familiarity with state Medicaid regulations (DHCS experience preferred)
  • Proficiency in Microsoft Office Suite and network management systems
  • Strong organizational and project management skills with the ability to manage competing priorities and deadlines

Why Join Us

  • Make a measurable impact on provider access and network quality
  • Collaborate with experienced healthcare leaders and cross-functional partners
  • Opportunity to contribute to network strategy, compliance, and growth initiatives
  • Competitive compensation and comprehensive benefits package

 

 

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