Provider Network Manager (Healthcare / Dental Insurance) - #1398106

Description

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This position supports our Southern California market and r egular travel within the region is required.

The Provider Network Manager is responsible for developing and maintaining a strong provider network, recruiting and retaining General Dentists and Specialists, and training providers to ensure compliance with Liberty's policies and procedures. The role involves building strategic relationships, analyzing market needs, and supporting providers with contractual and operational guidance. Regular travel is required to support recruitment efforts and conduct provider audits.

Job Summary Details

• Recruit General Dentists and Specialists for various networks to meet objectives at department and corporate levels.
• Review competitor information and propose strategies to meet recruitment needs.
• Analyze existing network providers and determine if additional recruitment of providers is necessary to meet access standards.
• Research and analyze fee schedules within assigned territory to determine cost effectiveness of contracting providers.
• Manage and service network providers within assigned territory according to established guidelines.
• Counsel providers with aberrant utilization or questionable billing patterns to ensure compliance.
• Educate and train providers on policies and procedures when necessary.
• Collect necessary contract documents from providers and follow up on outstanding paperwork.
• Conduct on-site structural audit and orientation according to established guidelines.
• Process and submit facility changes promptly to update internal systems.
• Establish and maintain strong relationships with providers to assure stable networks.
• Complete monthly activity reports and provide updates on various recruitment projects.
• Resolves more complex issues related to claims, grievances, and provider compliance.
• Performs other related duties as assigned.
  
  

Qualifications

Education/Experience

• 4 Year / Bachelor Degree or equivalent combination of education and relevant work experience.
• 4 Years' recent provider network management experience, dental office management, managed healthcare, and/or related sales, including prior experience working with Dental PPO or DHMO networks.
  
  

Specific Skills/Knowledge

• Knowledge of dental terminology.
• Strong presentation and public speaking abilities.
• Strong verbal and written communication skills in English; bilingual Spanish a plus.
• Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook, and SharePoint).
• Ability to negotiate fee schedules with providers.
• Must be detail oriented, strong customer service skills, strong organizational and time management skills.
• Ability to identify problems, research issues and follow through until resolved.
• Medicaid or Medicare experience preferred.
• Able to process provider contracts.
• Strong organizational and time management skills .
• Availability for occasional night and weekend travel for special events.
• Valid driver’s license, reliable transportation, and proof of insurance with a minimum liability of $100,000.
  
  

Location

Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States. Candidates for this position must currently reside in Southern California and be able to travel regularly within the assigned market.

What Liberty Offers

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That’s why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity.

Our first-class benefits package supports employees and their dependents with:

• Competitive pay structure and savings options to help you reach your financial goals.
• Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
• Affordable medical insurance, with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan.
• 100% employer-paid dental coverage for employees and eligible dependents.
• Vision insurance with low-cost premiums for employee-only coverage and dependents.
• Company-paid basic life and AD&D insurance, equal to one times your base salary, with options to purchase additional supplemental coverage.
• Flexible Spending Accounts for healthcare and dependent care expenses.
• Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance.
• Long-term disability coverage.
• Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts.
• Employee Assistance Program (EAP) to support mental health and well-being.
• Generous vacation and sick leave policies, with the ability to roll over unused time.
• 10 paid company holidays.
• Tuition reimbursement for eligible educational expenses.
• Remote or hybrid work options available for various positions.
  
  

Compensation

In the spirit of pay transparency, the base salary range for this position is $68,640 - $80,000, not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions.

Please note that the range listed represents the full base salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth.

Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture.

Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.

We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

Sponsorship and Relocation Specifications

Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.