The Director of Government Programs will oversee the utilization review processes for all states and all Sonrava Health/Western Dental facilities (ADS, BHD, Brident, STX, etc.) and their success based on metrics as outlined within each Program. Produce quarterly dashboards for the Ops team that reflect utilization and metric success within all offices and all Government Programs. Provide solutions for those offices failing to reach monthly and quarterly goals. Identify offices not meeting monthly quarterly metrics, work directly with the Ops and training team to create an effective training tool to produce desired outcomes. Build case for expanded membership assignment using data and tight management process. Collaborate with the Marketing team to develop effective outreach materials that will be successful in increasing membership into the office. Participate in Community Outreach to attend important events that provide substantial visibility, creating additional avenues to outreach to assigned and unassigned government membership. Generates dashboard reports specifically for the Senior Management and Executive Team members with clear and concise information. As a leader, fosters a culture within the Payor Relations department that reinforces customer service, teamwork and operational efficiency.
Responsibilities Responsible for coordination of new contract implementation, working in conjunction with Operations, IT, Training and OfficesResponsible for Payor relationships to resolve issues, seek clarification and represent Western Dental on operational issuesCompiles all Government data analyzes the information and create dashboards to illustrate KPI and presents this information to Senior Management and the Executive level teamReconciles monthly capitation data for retro debits and adjustmentsIdentify facilities that fall below metric thresholds, create CAPCreate training tools and collaborate with Operations and the Training department to facilitate regular courses and updatesWork closely with Business Managers and District Managers to meet all metricsBrainstorm marketing techniques to increase member appointments and show rateWork closely with the Community Outreach team to identify opportunities to increase Market BrandingPresent all methods of compensation through quality metric compliance Attend Government related meetings, i.e. MDAC, LA StakeholdersHandles all CAP directed by Government Programs Work directly with Payer Relations for decreasing or missing compensation or decreases in membership Other duties as identified by managementSalary Range: $115,000.00 - $140,000.00
Qualifications B.A. or B.S. Degree RequiredPrevious Supervisor Experience RequiredPrevious Experience performing statistical and financial analysisAbove average problem-solving skills and attention to detailMS Office with Advanced Excel skillsExcellent Communication and presentation skills Options Apply for this job onlineApplyShareEmail this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Not finding what you're looking for or not ready to make the leap quite yet?Join our Office Staff Talent Community or Hygienist & Doctor Talent Community to be the first to know about upcoming opportunities.
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