Manager Policy Quality Management

JOB DESCRIPTION

This position embraces a flexible hybrid working model, allowing for significant remote work opportunities. However, occasional in-office visits will occur for team meetings, office celebrations, and specific project requirements.

Delta Dental has office locations in Alpharetta, GA and throughout California, including in San Francisco, Oakland, and Rancho Cordova.

A candidate residing near these locations would be ideal.

The Manager of Policy Management & Provider Strategy is a key thought partner and leader that supports quality outcomes and accurate payment through oversight of provider strategy and support, policy review and coordination, and also internal and external education / awareness programs to enhance understanding of Policy and Payment Quality Management.

This role will work cross-functionally across the enterprise and also with external partners to execute the Quality function roadmap and its strategies.

RESPONSIBILITIES

• Through direct and indirect authority, leads initiatives and programs related to policy review, provider strategy, and education / awareness of payment quality management.
• Supports all lines of business, encompassing cross-functional collaboration across various departments including, but not limited to;

Sales, Claims, Dental Affairs, Actuary, Provider / Net Dev, Utilization Management, and Grievance and Appeals.

• Leads a team that are stewards for internal and external education, awareness, and communication for policy and payment quality management.
• Leads the coordination and management of the business policy decisioning council intake, triage, meeting cadence, notes and communication.
• Oversees the development and maintenance of centralized information related to how Delta Dental administers clinical and non-clinical policies, contractual requirements, and regulatory requirements to ensure quality outcomes, accurate payments and provider behavior improvements.
• Leads cross-functional collaboration to continuously refine the quality provider strategy, prioritization, and roadmap to support the provider stakeholder community and hold providers accountable to the highest level of quality.
• Participates in annual strategy and planning sessions and contributes to the development of support materials to ensure there is a clear Quality roadmap and plan to monitor and improve quality outcomes, payment, and provider behavior.
• Ensures the Policy and Payment Quality organization maintains clear strategic messaging to partners, thoughtful intra-organizational workflow and communication, organized department roadmaps, prioritization and backlog management, and operational reporting of initiatives and progress towards the department goals and strategies.
• Oversees the cross-functional design, implementation, and ongoing administration of enterprise provider incentive programs.
• Manages and develops multi-disciplinary teams to achieve strategic objectives, encompassing determining staffing needs, setting goals, monitoring performance, interviewing, selecting, coaching, and evaluating the performance of all direct reports, and overseeing, and maintaining department budgets.
• Works collaboratively to draft, publish and manage business policies.

QUALIFICATIONS

• 8+ years of professional experience with Bachelor's degree
• 1+ years supervisory / management experience
• Strong people leadership skillsets, including talent development and the ability to realize strategies through a team.
• High detail orientation with strong analytical, critical thinking and problem-solving skills.
• Excellent organizational / time management and project management skills.
• Extensive knowledge of health care industry.
• Excellent interpersonal, verbal, and written communication skills, including proven ability to collaborate and influence across all functions and levels of the organization.
• Proven ability to resolve conflict and facilitate decision-making.
• Ability to quickly extract key insights from complex data and details.
• Ability to translate an opportunity into an educational campaign, leveraging multiple mediums

Base Pay Information

The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications.

Other factors impacting pay include prevailing wages in the work location and internal equity. $92,000 - $196,500

ADDITIONAL INFORMATION

Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones.

This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes :

• Competitive base and incentive pay
• 401(k) with robust matching and non-matching contributions
• Rich medical & pharmacy benefits
• 100% employer-paid dental and vision benefits
• Holistic wellbeing program with deep financial incentives
• Generous paid time off plus 12 paid holidays and your birthday off
• Culture of growth and learning : career development; tuition reimbursement; recognition program
• Family support : adoption assistance, fertility treatment, child, elder & pet care assistance
• Social responsibility and volunteer opportunities
• Employee discount program

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Please note, Delta Dental will not sponsor applicants for work visas for this position.

LI-Hybrid

ABOUT THE TEAM

At Delta Dental, we're behind millions of smiles and counting. For over 68 years, we've served our communities by increasing access to affordable, quality care - but that commitment to care extends beyond the people we serve, to the dedicated employees who make those smiles genuine.

We've come this far by building equitable programs that offer opportunities for advancement, create meaningful connections and improve the lives of our employees and their families.

Because we know that when we take exceptional care of each other, we can make a positive impact for all.

We champion an inspirational workplace through our commitment to trust, service, excellence and innovation. Joining us means working for a company that offers stability and balance, opportunities for leadership at all levels, and a work environment focused on teamwork and camaraderie.

Discover the smiling faces behind Delta Dental and experience our values and culture in action by connecting with us on social media.

Follow Delta Dental Ins. on Facebook and Instagram, #LifeatDDins on Facebook and Instagram, Delta Dental Ins. on Twitter and Delta Dental Ins.

on LinkedIn. If you've got an appetite for innovation and want to be a part of a team that's transforming the future of health care, join us!

Since 1955, we have offered comprehensive, high-quality oral health care benefits to millions of enrollees and built the strongest network of dental providers in the country.

The Delta Dental of California network includes affiliates Delta Dental Insurance Company; Delta Dental of Pennsylvania;

Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; and Delta Dental of West Virginia, providing dental benefits to more than 31 million people across 15 states, the District of Columbia, Puerto Rico and the Virgin Islands.

The company and its affiliates are part of Delta Dental Plans Association (DDPA), a not-for-profit national association based in Oak Brook, Illinois.

Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.

S. territories. We offer vision coverage through DeltaVision in 15 states and the District of Columbia. Collectively, we deliver benefits to more Americans than any other dental insurance company.

Delta Dental is an equal opportunity employer. We are committed to building and maintaining a diverse and inclusive workplace for all employees.

Applicants will not be discriminated against because of race, color, religion, creed, national origin, ancestry, citizenship status, sex (including pregnancy), sexual orientation, gender or identity expression, age, disability, marital status, medical status, veteran status or any other status protected under federal, state, or local law.

In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico, District of Columbia (Washington D.

C.) or other US Territories at this time.

Proof of eligibility to work in the United States must be provided if selected for hire.

Delta Dental includes : Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, and Delta Dental of New York

If You Are A Current Employee Click Here To Apply