Blue Cross Blue Shield of Massachusetts Dental Network Manager in Hingham, Massachusetts

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This position manages the daily operations of individual dental providers and large complex dental provider groups and networks within the state of Massachusetts. Ensures Dental Blue members have access to a robust, high quality provider network by recruiting, contracting and maintaining relationships with providers. Promotes positive relationships with providers and the associations that represent them. Provides continuous training regarding plan policies and procedures to providers. Promotes technology solutions to reduce overall administrative costs. Maintains provider participation with participating plans. Strategically identifies and develops dental provider networks to anticipate and meet future market needs.

Key Accountabilities:

  • Manages BCBSMA’s relationship with Dentists, and office support staff within an assigned territory by becoming the “face” of BCBSMA.

  • Maintains a corporate liaison position between our community dentists and the organizations, which represent them.

  • Recruit new dental providers into our dental networks to ensure adequate access to care for our members.

  • Manages and ensures all provider contracts and contractual conditions of participation paperwork are accurate and complete.

  • Works with Sales, Marketing and Service areas to define, build and maintain dental networks.

  • Provides on-site education and issue resolution for all dental product lines through consistent outreach visits.

  • Provides information to dental offices regarding BCBSMA technology tools and resources to strengthen communication with the provider community.

  • Works in collaboration with the Member and Provider Communications team to develop and implement training and communications tools to assist the dental community in delivering high quality care to our members.

  • Be aware of, communicate, understand and interpret global competitive strategies.

  • Work cooperatively with teammates / partners across multiple states to share information, ideas and solutions to ensure that the dental provider community needs are met on a timely basis.

  • Act as a consultant/coach in conjunction with appropriate internal / external partners, to assist dental providers in effectively managing their patient’s care.

  • Manage the corporate interdependencies to assure timely resolution of complex dental provider issues to strengthen our relationships with the dental community.

  • Serve as a resource for dental providers to answer questions, keep them informed about administrative policies and procedures related to contract issues, claims issues, dental policy, member education, etc.

  • Maintain visibility in the dental community.

  • Work within the team to improve provider satisfaction according to corporate/division goals. Identify problems that would be a barrier to achieving goals and resolution to these problems.

  • Support all corporate contract compliance initiatives.

  • Support corporate regional and national dental provider accesses strategies.

  • Represent Dental Network Management on corporate committees to strengthen business relationships and ensure adequate representation of dental.

  • Anticipate and prepare network for changes in dental market. Take initiative to grow networks as product/ accesses dictates.

  • Represent BCBSMA at annual Yankee Dental Conference.

  • Utilize resources, as available, to plan professional development.

  • Foster an atmosphere of collaborative teamwork within the department, division and company.

  • Promote and foster diversity.

Qualifications (knowledge/skills/abilities/behaviors):

  • Proven success in managing and achieving business goals and objectives.

  • Excellent interpersonal skills as demonstrated in successful business and team relationships.

  • Ability to resolve business issues and make decisions in a fast paced customer service environment.

  • Demonstrate flexibility and adaptability

  • Support and participate on internal projects as defined

  • Demonstrated strength in identification of problems and problem resolution.

  • Strong presentation skills, including use of webinar and other technologies as needed.

  • Motivated self-starter with personal integrity.

  • Knowledge of existing BCBSMA systems, business function and high level processes desired.

  • Effective time management skills

  • Ability to work with diverse population both internal and external

  • Demonstrates personal and professional accountability for decisions and actions

  • Capacity to influencing others Demonstrated ability to understand provider contracts

Background and Experience

  • BA or BS degree

  • 3-5 years relevant experience Dental Clinical experience, Hygienist, Dental Assistant or equivalent preferred

  • Dental administrative training experience preferred

#LI-DNI

LocationHingham, QuincyTime TypeFull time

Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power, Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.

Our Commitment to You

We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.

Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.