Director of Insurance Plan Management

Dental Care Alliance • , FL

1d

About The Position

The Director of Insurance Plan Management leads end-to-end negotiations with commercial and government-sponsored dental payers to support Dental Care Alliance’s growth and profitability. The role owns strategy and execution for pricing, contract structures, and network participation, partnering with operations, clinical leaders, analytics, and the insurance team to drive revenue growth and market expansion.

The position develops payer and market strategies, evaluates financial and operational impacts of proposed contract terms, and builds relationships with payer organizations. It also supports plan participation decisions, resolves provider-payer disputes, builds negotiation capabilities across the organization, and reports performance against goals. The role collaborates with revenue cycle, operations, and clinical leadership to align insurance plan management with organizational objectives and improve related processes and technology.

Requirements

• Bachelor’s degree in business, healthcare administration, economics, or a related field.
• At least 10 years of experience in payer relations or operations.
• Deep understanding of dental reimbursement models, including FFS, PPO, capitation, and value-based models, as well as coding and claims dynamics and payer policy trends.
• Advanced financial acumen and expert-level Excel or Sheets modeling and sensitivity-analysis skills.
• Ability to present trade-offs to executives in real time.
• Proven change leadership and ability to align cross-functional stakeholders and turn complex strategies into clear execution plans.
• Exceptional communication and relationship skills, high emotional intelligence, and credible executive presence.
• Ability to travel up to 25%.
• Ability to work effectively in a fast-paced, growth-oriented, partially remote environment.

Nice To Haves

• MBA or MHA.

Responsibilities

• Lead strategic negotiations with commercial and government dental payers to secure fee schedules, value-based arrangements, and performance incentives that improve margin and growth.
• Build, pressure-test, and present financial pro formas and scenario models, quantifying the effects of proposed terms on revenue, contribution margin, and provider economics.
• Develop market-level portfolio strategies by assessing payer mix, identifying plan additions or exits, and optimizing network participation to support patient access and enterprise value.
• Use external market intelligence and internal performance data to set negotiation priorities and shape deal design.
• Partner with field operations and clinical leadership on plan participation, fee-schedule rollouts, provider onboarding, and related workflow changes.
• Develop senior-level relationships with payer organizations and establish quarterly business reviews and issue-resolution pathways.
• Resolve complex provider-payer disputes by addressing root causes, data quality, processes, and escalation protocols.
• Create negotiation playbooks, templates, and best practices, and coach teammates and field leaders.
• Track performance against budget and course-correct with clear actions, owners, and timelines.
• Drive key performance indicators related to insurance plan management and create management-level reports to support data-driven decisions.
• Collaborate with revenue cycle, operations, and clinical leadership to align insurance plan strategies with organizational goals.
• Identify opportunities for process improvement, technology implementation, and innovation in insurance plan management.

What This Job Offers

• Job Type: Full-time
• Career Level: Director