Sr. Provider Network Manager

Liberty Dental Plan Careers•City of Oswego, NY

1d•Hybrid

About The Position

We’re hiring a Senior Provider Network Manager to Lead the relationships and strategy behind our leased provider networks. The Sr. Provider Network Manager is responsible for developing, recruiting, and sustaining a high-performing dental provider network to support Liberty Dental Plan’s business objectives and regulatory requirements. This role leads provider recruitment and retention efforts, ensures network adequacy and compliance, and serves as a strategic partner to providers and internal stakeholders. The Sr. Provider Network Manager analyzes market dynamics, negotiates provider contracts, and educates providers on Liberty’s policies and procedures to deliver quality access and service to members. Regular travel is required to support recruitment initiatives, provider audits, and relationship management.

Requirements

Bachelor’s degree in Healthcare Administration, Business, or a related field required
Equivalent combination of education and relevant experience may be considered
Minimum of 6 years of experience in provider network management, dental office management, managed healthcare, or related provider-facing roles
Prior experience with Dental PPO and/or DHMO networks strongly preferred
Previous insurance network management experience required
Contracting and customer service experience strongly preferred
Medicaid and/or Medicare experience preferred
Strong working knowledge of dental terminology and dental practice operations
Proven ability to recruit, negotiate, and contract with dental providers
Strong presentation, facilitation, and public speaking skills
Excellent verbal and written communication skills; bilingual skills a plus
Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
Strong organizational, time management, and prioritization skills
Detail oriented with a high degree of accuracy and follow-through
Ability to analyze problems, research issues, and drive resolution independently
Understanding of provider compliance, utilization review, and billing practices
Ability to process and manage provider contracts and documentation
Availability for night and weekend travel for special events, as needed
Valid driver’s license, reliable transportation, and proof of insurance with a minimum liability of $100,000.

Nice To Haves

Bilingual skills a plus

Responsibilities

Recruit general dentists and dental specialists to meet access, growth, and network adequacy standards across assigned territories
Analyze existing provider networks to identify recruitment gaps and ensure compliance with access standards
Review competitor and market data to develop effective recruitment strategies
Research, analyze, and evaluate fee schedules within assigned territories to ensure cost-effective contracting
Negotiate contract terms and fee schedules with existing and prospective providers
Collect, review, and submit required contract documentation for accuracy and completeness
Manage and service contracted network providers in accordance with established guidelines and policies
Establish and maintain strong, collaborative relationships with providers to ensure network stability and satisfaction
Serve as a primary point of contact for escalated provider and member issues, coordinating resolution with internal teams
Conduct provider orientations and ongoing education related to Liberty’s policies, procedures, and operational requirements
Ensure network compliance with annual attestation and regulatory requirements
Conduct service calls, site visits, and provider audits as required by contract or compliance standards
Assist with counseling providers demonstrating aberrant utilization or questionable billing practices in partnership with leadership
Process facility changes and submit timely updates to internal systems
Prepare and analyze quarterly network performance reports, trends, and summaries
Conduct external-facing communications with clients and internal-facing communications with cross-functional partners
Evaluate and analyze provider fee increase requests and present recommendations with justification to executive leadership
Create and maintain DSO and group provider contracts
Support Provider Relations leadership with day-to-day operational needs and strategic initiatives
Assist in developing and delivering training for Network Managers on functional and operational topics
Participate in special projects and cross-departmental initiatives as assigned
Travel as required, including occasional nights and weekends, to support provider engagement and events
Perform other duties as assigned

Benefits

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.