You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.
DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.
Job Description:
Location: We support US virtual working arrangements in the contiguous 48 states.
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At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America
The opportunity:
The Manager, Provider Enrollment & Credentialing is responsible for the management and monitoring of staff and systems which support the accurate and timely tracking and monitoring of provider related enrollment and credentialing activities.
How you will contribute:
- Oversee enrollment and credentialing of Providers in accordance with requirements (NCQA, CMS, DDPA, etc.).
- Collaboratively work with Quality Assurance to ensure an effective audit process which will result in the ability to develop staff training content.
- Ensure company’s processes meet client expectations, Federal and state regulations.
- Assist with credentialing audits as needed.
- Ensure all Applications are tracked.
- Manage staff members to ensure high performing teams
- Complete necessary reporting to ensure staff members are completing work within the established TAT and accuracy.
- Complete necessary reporting to ensure staff members are meeting productivity requirements.
- Production of monthly staff member scorecards.
- Train and motivate team members.
- Conduct monthly one on one session for coaching and mentoring.
- Write and deliver corrective action plans when appropriate.
- Create a culture that embraces company’s vision, mission and goals.
- Continuously evaluate resources to ensure they are appropriately allocated to meet all Provider Operations deadlines and required outcomes.
- Implement, monitor and maintain process changes resulting from corrective action plans.
- Identify issues and inefficiencies to make recommendations for process improvements.
- Resolve complaints and issues with providers.
- Engage and maintain relationship with internal customers to ensure provider satisfaction.
- Serve as a SME to advise our internal and external customers to proactively meet customer needs.
- Coordinate and implement appropriate performance management strategies for team members to include:
- Actively participates in the hiring process, including interviewing candidates.
- Actively participate in preparation of performance and wage evaluations in accordance to company policy.
- Monitor and manage attendance and company approved time off for team members.
- Update management team timely on any concerns or issues.
- Other duties as assigned.
What you will bring with you:
- Bachelor’s degree in Health Care or relevant field, preferred.
- 3+ years of supervisory experience required.
- Knowledge of NCQA, CMS and other quality requirements preferred.
- Excellent PC skills with proficiency in MS Office products.
- Excellent oral and written communication skills.
- Strong customer service and analytical skills.
- Strong Project management and process improvement skills.
- Ability to manage staff and work well with others.
- Ability to prioritize and organize multiple tasks and remain organized with multiple interruptions.
- Ability to meet multiple deadlines.
- Ability to work in excess of 40 hours per week, as needed or required to meet business objectives.
Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.
Not ready to apply yet but want to stay in touch? Join our talent community (https://pages.beamery.com/sunlifecareers/page/join-us-canada) to stay connected until the time is right for you!
Life is brighter when you work at Sun Life
- Excellent benefits and wellness programs to support the three pillars of your well-being – mental, physical and financial – including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more
- Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account
- A flexible work environment with a friendly, caring, collaborative and inclusive culture
- Great Place to Work® Certified in Canada and the U.S.
- Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
If you are a California resident, the salary range for this position is:
- Southern region: $51,500 - 77,200 annually
- Central region: $54,300 - 81,400 annually
- Northern region: $58,000 - 87,000 annually
If you are a Colorado resident, the salary range for this position is $49,100 - 73,700 annually.
If you are a New York resident, the salary range for this position is $58,000 - 87,000 annually.
If you are Washington resident, the salary range for this position is $54,200 - 81,400 annually.
We consider various factors in determining actual pay including your skills, qualifications, and experience. In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits.
Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more.
At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.
Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email recruitingUS@sunlife.com to request an accommodation.
At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.
For applicants residing in California, please read our employee California Privacy Policy and Notice.
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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran
