Senior Manager, Provider Engagement, DentaQuest - South Carolina

Sun Life•Columbia, SC

19h•Hybrid

About The Position

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK. Candidates must reside in the state of South Carolina. The Senior Provider Network Manager provides guidance and oversight to Provider Partners regarding benefit programs, policies, and procedures. The position handles identifying and addressing network gaps, recognizing and implementing process improvement opportunities, and monitoring CAP performance. This position mentors and coaches their team in provider recruitment and engagement. In addition to managing staff, the role may also have responsibility for covering larger or more complex situations and markets.

Requirements

Bachelor’s degree in Business, Healthcare Administration (or related field) or equivalent, relevant experience.
5 years of experience in healthcare practice or managed care environment.
Excellent verbal and written communication skills.
Ability to work alone and as part of a team.
Knowledge of Microsoft Office.
Proven problem-solving skills.
Problem-solving and training experience.
Ability to make sound judgment conclusions based on data available with minimal oversight.
Up to 20% of travel as needed.

Nice To Haves

5 years’ supervisory/management experience preferred
Experience in a managed care environment preferred

Responsibilities

Manage and Guide provider engagement staff
Ensure provider engagement staff recruits providers within cost and access goals
Authorize and negotiate special deals
Develop strategic action plan to address network gaps
Develop provider education curriculum and approach
Cover more markets or highly complex markets
Organize amendment and recruitment projects
Develop project plans, internal/external reports, and ensure deliverables are met
Identify and coordinate implementation of quality/cost improvements
Manage reporting process to identify and modify provider outliers
Provide cross-market aid as needed
Analyze and monitor provider performance reports
Participate in and often present during client, organized dentistry and key stakeholder meetings/events
Identify continuous improvement opportunities
Manage CAP office performance
Coordinate and implement appropriate performance management strategies for team members to include: Assist in the hiring process, including interviewing candidates. Assist, train and motivate team members. Evaluate and measure effectiveness of team members. Assist in preparation of performance and wage evaluations in accordance with company policy. Manages attendance and company-approved time off for team members. Participate in the drive and implementation of Performance Improvement Plans and performance management initiatives.
Other duties as assigned