Sr. Manager, Credentialing & Third Party Payer Advocacy
The American Dental Association is dedicated to promoting the public's health through its initiatives in research, education, advocacy, public awareness and the development of standards. We have an exciting opportunity for a Sr. Manager, Credentialing & Third Party Payer Advocacy.
This position is responsible to manage the ADA's Credentialing Service and provide oversight for the ADA's Third Party Payer Advocacy efforts. Management of the ADA's Credentialing Service requires working with an interdivisional team including staff from at least Information Technology, Communications, Government Affairs, Membership Data Center and Product Development to maintain and update the service to provide the best user experience for both dentists and payers. It requires relationship management with CAQH, the credentialing solution vendor, dentists and private dental benefit plans and their provider network administrators. This person is responsible for identifying issues based on dentist and payer feedback and guiding the development of solutions to address these issues. Success is dependent on dentist and payer adoption and continued use of the ADA's Credentialing Service. This person also provides oversight to the ADA's Third Party Advocacy efforts through supervision of staff involved with providing member support and education on third party payer issues. It requires relationship building with third-party benefit administrators and dental consultants and presenting ADA's position to third party payers regarding both commercial and public programs (i.e. Medicaid and Medicare).
Requirements: This position has the following minimum requirements:
A minimum of 3 years' experience in dental or medical benefit plan network management and /or network administration including credentialing.
Prior product management experience working on complex projects related to customer value.
Able to connect strategic vision, goals with day to day execution.
Ability to influence others directly and indirectly to share information and take action towards shared objectives.
Manage multiple priorities, meet deadlines and deliver innovative and compelling value to customers in collaboration with internal content experts, key external client channels and multiple stakeholders.
Must be a self-starter, results-focused and able to effectively establish priorities and accomplish outcomes.
Excellent oral/written communications, analytical, facilitation and negotiation, collaborative and interpersonal skills.
Solid spreadsheet, presentation and other decision support computer skills.
Extensive knowledge of data management/integrity concepts.
Strong presentation skills and interpersonal communication.
Work Evenings and Weekends.
Highly desirable skills include:
Project management including managing large interdivisional teams to achieve customer and revenue growth goals, including success measures and timelines for bringing products to market.
Specific experience within the dental benefits industry.