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Dental Payer Relations Specialist

Company: Great Expressions Dental Centers
Location: Southfield
Posted on: July 30, 2022

Job Description:

Great Expressions Dental Centers (GEDC) is one of the most established, single brand dental organizations in the United States. - Founded in Michigan over 45 years ago and now serving patients in nine states across 250 dental offices, the Great Expressions strategic objective is to become the leading national Dental Services Organization-fueled by the Best Team Members working in a Best Place to Work culture that culminates in delivering the Best Patient Experience in the industry. -An experienced negotiator, the Senior Dental Payer Relations Specialist position (remote setting ok) is accountable for working with the VP, Payer Relations and Credentialing to support all aspects of payer contracting strategies and payer fee negotiations for Great Expressions Dental Centers (GEDC) that support revenue growth. -

Lead payer contract fee negotiations and renegotiationsBuild and maintain payer analytics capability to benchmark utilization and reimbursement levels across the growing GEDC 250-office networkEvaluate new payers/networks and their fees for participationWork with outside consultants and contracted third-parties with respect to payer relationsThoroughly analyze and review rates and utilization in order to drive mutually beneficial outcomes for dental patients and providersAnalyze fee schedules by specialty and code relative to historical company utilization and industry compsTrack contracts and anniversary dates to ensure annual rates are implemented correctly and on timeQuantify rate impacts during negotiations and monitor ongoing utilization and expected fee changesAssist in developing and maintaining appropriate policies, procedures, and controls for dental contracts and payer contracting activityBuild large data models to forecast and monitor payer rates by codeBuild and deepen relationships with key contacts at payers through ongoing communications; keep a record of conversations with payers, schedule periodic phone calls and update payer contact listsResolve escalated issues with payersRun and distribute revenue, impact analysis and other reportsAudit invoices from consultants and submit for paymentDevelop presentations to report on progress and resultsOther duties as assignedRequired Skills/Abilities:
Analytical ability and experience managing large data sets Track record of success working in an environment of collaboration, transparency, mutual respect, and passion for excellence and innovationMust be able to communicate and work effectively with all levels of employees and managementStrong organizational, project planning and project management skills are requiredProven ability to translate high-level business requirements into an operational product/serviceExcellent financial and business acumenExperience in healthcare is preferred, but not requiredEducation & Experience:
2-3 years of experience with a DSO (Dental Service Organization) requiredPrior fee analysis and negotiations experience requiredBachelor's degree required, preferably in a quantitative field; MBA or advanced degree a plusAdvanced Excel skills are a mustActuarial experience/qualifications highly desirableStrong organizational skills, accuracy and attention to detailHigh level of maturity, personal initiative, and sound judgmentStrong work ethicDental experience and a knowledge of CDT codes and dental terminology requiredDental EHR system experience is a plusComfort level with using Power BI, think-cell, VBA Macros a plusSalary commensurate with experience

Keywords: Great Expressions Dental Centers, Southfield , Dental Payer Relations Specialist, Healthcare , Southfield, Michigan

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