Director of Insurance Plan Management

The Negotiations Director accelerates Dental Care Alliance's growth and profitability by leading end-to-end negotiations with
commercial and government-sponsored dental payers. This role owns the strategy and execution for pricing, contract structures,
and network participation, partnering closely with operations, clinical leaders, analytics, and the insurance team to deliver
measurable revenue lift and market expansion

Lead strategic negotiations with dental payers (commercial and government), securing optimal fee schedules,
value-based arrangements, and performance incentives that materially improve margin and growth.
Build, pressure-test, and present dynamic financial pro formas and scenario models; quantify impacts of proposed terms
on revenue, contribution margin, and provider economics.
Own a market-level portfolio strategy: assess payer mix, identify adds/exits by plan, and optimize network participation to
maximize patient access and enterprise value.

Synthesize external market intel (competitor positioning, payer strategies, regulatory shifts) and internal performance data
to inform negotiation priorities and deal design.
Partner with field operations and clinical leadership to align on plan participation, fee-schedule rollouts, provider
onboarding, and downstream workflow changes.
Develop senior-level relationships at payer organizations; establish quarterly business reviews and issue-resolution
pathways to improve cycle time and outcomes.

Resolve complex provider-payer disputes: remove root causes by tightening data guality. processes, and escalation protocols

Create negotiation playbooks, templates, and best practices; coach teammates and field leaders to raise
organization-wide negotiating capability.
Track and report performance versus budget, course-correct with clear actions, owners, and timelines.

Candidate Attributes
Outcome-obsessed dealmaker who prepares meticulously and neqotiates with data, empathy, and firmness.

Strategic, systems thinker who connects payer strategy to practice-level operations and patient experience.
Builder-coach mindset; creates repeatable playbooks and raises the bar for the broader team.
Resilient, adaptable, and energized by ambiguity and rapid growth.
Leverages CRM/contract repositories, analytics dashboards, and standardized playbooks to manage a disciplined
pipeline, QBR cadence with payers, and transparent executive reporting.

Performance Metrics: Drive key performance indicators related to insurance plan management. Work autonomously to create
management level reports to enable data-driven decision-making.
Collaboration: Work closely with cross-functional teams, including revenue cycle, operations, and clinical leadership, to align
insurance plan management strategies with overall organizational goals.
Continuous Improvement: Identify opportunities for process improvements, technology implementation, and innovation to
enhance insurance plan management practices within the DCA.

Bachelor's degree in business, Healthcare Administration, Economics, or related field; MBA/MHA preferred.
10+ years in payer relations or operations.
• Deep understanding of dental reimbursement models (FFS, PPO, capitation, value-based), coding/claims dynamics, and
payer policy trends.
• Advanced financial acumen; expert in Excel/Sheets modeling and sensitivity analysis; comfort presenting trade-offs to
executives in real time.

Proven change leadership aligns cross-functional stakeholders and converts complex strategies into clear execution
plans.
Exceptional communication and relationship skills; high EQ and credible executive presence.
Ability to travel up to 25%; effective in a fast-paced, growth-oriented, and partially remote environment.