Execute Payer Strategy mission to negotiate and maintain the best terms and compensation with dental carriers for MB2 Dental (MB2) affiliated offices. Primary responsibilities include growing dental plan revenue, serving as a key liaison between MB2 offices and the carriers, and supporting the offices, Credentialing and Central Business Office (RCO) with strategic advice and daily maintenance.
DUTIES AND RESPONSIBILITIES
- Negotiate contracts and compensation, pursue member assignments, prospect and present new Plans
to Operations, in order to optimize Plan revenue and explore new partnerships.
- Conduct Payer Portfolio Reviews for individual offices upon request.
- Conduct analysis for struggling offices and create a Payer strategy.
- Serve as single point of contact with assigned national accounts and key liaison between MB2 and all
regional carriers to resolve daily issues that arise.
- Serve as subject matter expert/information resource on assigned Payers for MB2 internal audiences.
- Work closely with Payers to ensure proper understanding of Payer guidelines, contractual terms, and
claims processes, and monitors legislation that impacts Payer products and reimbursement.
- Actively manage all assigned Payer relationships including, but not limited to, regularly scheduled
reviews to discuss opportunities, and reimbursement.
- Partner with internal departments, such as RCO and Credentialing, to research and resolve Payerrelated issues.
- Facilitate implementation of operational efficiencies, such as EDI, EFT, ERA, web portals, and delegated
- Coordinate office training on how to maximize PPO and DHMO plan participation.
- Coordinate patient grievance resolution, as needed.
- Perform other related duties, as assigned.
COMPETENCIES AND SKILLS
- To perform the job successfully, an individual should demonstrate the following competencies:
- Gather and analyze information skillfully.
- Able to think strategically and communicate recommendations to senior management.
- Able to project revenue streams, conduct post-launch profitability analysis, and draw conclusions with
- Relationship Management Skills
- Interpersonal Skills: able to develop productive business relationships inside/outside the company.
- Prospecting: able to identify viable business opportunities through data collection and analysis.
- Ability to interact effectively with senior management in a cross-functional manner.
- A strong character with a personal passion for professional growth and customer service.
- Communication Skills
- Language: able to read, write and speak English fluently.
- Oral: speaks clearly and persuasively; effectively presents information and responds to questions.
- Written: independently writes professional business correspondence; presents numerical data
- Presentation: effective presentation skills with the ability to present to small groups of people.
- A positive attitude and desire to work in a team environment.
- Organizational Skills
- Time Management: ability to organize and prioritize workload.
- Administrative Skills: detail oriented; pays close attention to accuracy.
- Strong follow-up skills.
- Computer Skills
- Computer literate.
- Software: working knowledge of Microsoft Office including Outlook, Word, and PowerPoint.
- Software: advanced knowledge of Microsoft Excel, including ability to create, manipulate, analyze and
- Working knowledge of the Internet, Internet browsers, and search engines.
EDUCATION AND EXPERIENCE
- Bachelor’s degree desired.
- Dental industry experience preferred.
- Two to five years of dental office and/or dental plan experience desirable.
- Equivalent combination of education and experience.
- Limited travel -- 10-15% of the time.
- Minimal overnight travel required.
CERTIFICATES, LICENSES, REGISTRATIONS
POTENTIAL NEXT POSITION(S)
- Director of Payer Strategy