Dental Operations Manager
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Job Description
Dental Operations Manager overseeing dental operations for Medi-Cal, Healthy Families, and Medicare members. Responsible for compliance, monitoring, and provider network management.
Responsibilities:
- Managing, directing and supporting the dental operations for Medi-Cal, Healthy Families and Medicare members
- Ensuring compliance with Department of Health Services (DHS) and Healthy Families MRMIB contracts
- Monitoring Health Net's performance under its dental services contracts
- Overseeing Health Net's dental administration functions performed by third party administrator
- Acting as point person for provider relations and inquiries
- Maintaining and expanding provider network through contract negotiations
- Ensuring that the dental care provided meets acceptable standards
- Performing utilization review by reviewing claims and encounter data
- Developing and implementing policies and procedures for the dental plan
- Assisting in grievance resolution related to quality of care under the dental plan
- Actively participating in plan grievance procedures
Requirements:
- College degree in Business preferred
- Five to ten years managed care dental experience
- Prior experience with negotiating provider contracts preferred
Benefits:
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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