Director of Dental Program

Commonwealth of Massachusetts • Quincy, MA

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About The Position

MassHealth is seeking applicants for the Director of the Dental Program. This position is a key management role that is responsible for providing overall guidance and oversight for MassHealth’s $500M+ dental program and serves as a co-leader with the Dental Clinical Director in shaping program strategy, benefit design, and performance and quality outcomes. The Director is responsible for helping to set the agency’s overall dental policy, including rates, covered services, and utilization management via regulatory and sub-regulatory guidance, as well as direct stakeholder outreach and management of MassHealth’s dental vendor.
The Director is responsible for managing all dental related contracts, including the dental third-party administrator (TPA) contract with an external vendor. This includes managing all contract requirements and reporting, frequent communication with the vendor, triaging issues and escalations, and managing process improvement projects.
The Director is also responsible for facilitating internal and external stakeholder engagement and ensuring MassHealth members have access to a robust network of dental providers. Additionally, the Director is responsible for implementing new initiatives and managing the development and cost growth of the MassHealth dental program, as well as responding to routine audits and supporting other program integrity efforts.

Requirements

• Applicants must have at least (A) six (6) years of full-time or, equivalent part-time, professional, administrative, supervisory, or managerial experience in business administration, business management, public administration, public management, clinical administration or clinical management of which (B) at least two (2) years must have been in a project management, supervisory or managerial capacity or (C) any equivalent combination of the required experience and substitutions below.

Nice To Haves

• Knowledge and working experience in Medicaid services, Dental and Oral Health Care environment, laws, regulations, and/or polices.
• Excellent analytic, interpersonal, project management, negotiation and leadership skills.
• Excellent communication skills; and Demonstrated experience with health care quality improvement processes.

Responsibilities

• Manage MassHealth’s dental TPA vendor, including ensuring contract requirements are met, reviewing reporting, implementing process improvements, and supporting escalations and issue resolution.
• Lead dental program operations, including regulatory and sub-regulatory policy development and implementation, rate-setting, vendor oversight, and compliance activities.
• In partnership with Dental Clinical Director, co-lead program strategy, including coverage and utilization management updates, new initiatives, and program performance and quality outcomes, and jointly determine final policy recommendations for leadership consideration.
• Support financial reporting and routine audit requests. Ensure robust member access to dental providers and services.
• Manage staff who support TPA contract management, policy development and implementation, provider outreach, audit responses, and data and analytics.
• Provide routine updates and information to senior leadership, support legislative reporting and ad hoc inquiries, and respond to stakeholder outreach.

Benefits

• When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
• Explore our Employee Benefits and Rewards!

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees