Dental Operations Manager

Dental Operations Manager

locations

Remote-CA

time type

Full time

job requisition id

1637516

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: The Dental Operations Manager is responsible for managing, directing and supporting the dental operations for our Medi-Cal, Healthy Families and Medicare members. The director is also responsible for ensuring compliance with our Department of Health Services (DHS) and Healthy Families MRMIB contracts.

• Monitors Health Net's performance under its dental services contracts with the State. Ensures compliance with all aspects of the contracts.
• Oversees Health Net's dental administration functions that are performed by the designated third party administrator. Monitors administrator’s performance against contract.
• Acts as point person for provider relations and inquiries.
• Maintains and expands provider network through contract negotiations and execution.
• Works closely with Dental Director to ensure that the dental care provided meets the standards for acceptable dental care.
• Performs utilization review by reviewing claims and encounter data.
• Develops and implements policies and procedures for the dental plan.
• Assists in grievance resolution related to quality of care under the dental plan.
• Actively participates in plan grievance procedures under the dental plan.
• Makes recommendations as needed to HN management on ways to improve/enhance dental operations

Education/Experience: College degree in Business preferred.
Five to ten years managed care dental experience.
Prior experience with negotiating provider contracts preferred.

Location: Candidate must live in CA. Will require some travel.

Pay Range: $107,700.00 - $199,300.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.