Payer Relations Manager

Dental Office•Carrollton, TX

About The Position

MB2 Dental, a first-of-its-kind Dental Partnership Organization (DPO) founded in 2007, is seeking a Payer Relations Manager to join our team in Carrollton, TX! This is an excellent opportunity to work in a highly collaborative environment while independently managing multiple tasks and responsibilities. Negotiate and maintain the best terms and compensation with dental payers for MB2 Dental (MB2) affiliated offices. Responsibilities include optimizing dental plan participation, navigating rental (lease) networks, serving as a key liaison between MB2 offices and Payers, and providing strategic Payer advice to the offices, Credentialing, and Central Business Office. MB2 Dental is pleased to offer a competitive compensation package that includes medical/dental/vision/life insurance, long- and short-term disability, generous PTO, paid holidays, traditional and Roth 401(k) options, and more.

Requirements

Analytical Skills Gather and analyze information skillfully with the ability to create Action Plans.
Prospecting: able to identify viable growth opportunities through data collection and analysis.
Think strategically and communicate recommendations to senior management.
Project revenue streams, conduct post-launch profitability analysis, and draw conclusions with recommendations.
Relationship Management Skills Interpersonal Skills: able to develop productive business relationships inside and outside MB2 Dental.
Negotiation Skills: experienced negotiator, able to reach mutually beneficial agreements.
Communication Skills Language: able to read, write, and speak English fluently.
Oral: speaks clearly and persuasively; effectively presents information.
Written: writes professional business correspondence; presents numerical data effectively.
Presentation: effective presentation skills with the ability to present to small groups of people.
Organizational Skills Initiative: self-motivated, requiring minimal supervision while working remotely.
Time Management: able to organize and prioritize workload and execute tasks in a timely manner.
Administrative Skills: detail-oriented; pays close attention to accuracy.
Computer Skills Strong computer/PC skills Software: working knowledge of Microsoft Office, including Outlook, Word, and PowerPoint Software: advanced knowledge of Microsoft Excel, including the ability to create, manipulate, analyze, and interpret spreadsheets.
A bachelor’s degree is desirable.
Understanding of all dental benefit models, including FFS, Indemnity, PPO, EPO, DHMO, Discount, Medicaid, and Medicare Advantage structures.
Understanding of rental / leased networks.
10 years of dental industry experience
Two to five years of dental provider experience is required

Nice To Haves

experience with dental plans is a plus.
An equivalent combination of education and experience is considered.

Responsibilities

Optimize existing Payer participation by negotiating all contract terms and compensation, and pursuing Plan membership on a regular cadence.
Review Payer Agreements to identify and negotiate language that minimizes risk to Providers.
Understand the differences between direct and indirect Payer relationships (network leases) and their implications for reimbursement.
Prospect new Payers Network offerings and present analysis of strengths and weaknesses to the offices for consideration.
Analyze Payers with inferior fees and/or membership and present findings to offices for TERM consideration.
Serve as primary MB2 contact with assigned (national) Payers to resolve high-impact issues.
Serve as subject matter expert/information resource on assigned Payers for MB2 internal audiences, including understanding carrier guidelines, contractual terms, and claims processes.
Actively manage assigned Payer relationships, including hosting regularly scheduled reviews to discuss opportunities for increased partnership and reimbursement.
Support internal departments, such as RCO and Credentialing, in researching and resolving payer-related issues that impact multiple Practices.
Support implementation of operational efficiencies, such as EDI, EFT, ERA, web portals, and delegated credentialing.
Coordinate patient grievance resolution with the Compliance Department as needed.
Monitor state and federal legislation that affects Payer products and reimbursement.
Perform other related duties, as assigned.