Mgr - Provider Relations & Data Management

Government Employees Health Association, Inc. (G.E.H.A) is a nonprofit member association that provides health and dental benefits that millions of federal employees and retirees, military retirees and their families have counted on since 1937. Offering one of the largest health and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care.

G.E.H.A has one mission: To empower federal workers to be healthy and well.

Manages the operations of the Connection Dental Network Provider Relations and Data management teams . Responsible for establishing and maintaining processes and systems to operate provider contract administration and provider data management. In addition, oversight of network content management such as provider-facing websites, newsletters, surveys, and various other interactions. . Provides input into strategic decisions that affect the functional area of responsibility, including budget suggestions. Responsible for the operations of the Connection Dental network, including provider contract administration, , and ongoing maintenance of provider participation, including provider demographic updates, CMS requirements and provider issue resolutions. Participates in strategic planning regarding all network activities; evaluates network market data and trends, recommends new network strategies including, provider experience, provider retention strategies and overall network operational direction. Works closely with Dental stakeholders across the organization to support and promote quality, strategic growth, retention objectives, provider and client satisfaction.

SKILLS

Duties and Responsibilities

• Works with the Director, Dental Network to provide feedback and information to develop and adjust provider relations and data strategy, to drive process efficiency and effectiveness.
• Recommends and implements improvements to the contracting process, including contract language, negotiations, fee schedules, network savings, retention strategies, data management and service issue resolution. 
• Works with other network management team members to support contracting process between the network and GSI, to ensure that legal and provider contractional obligations, network objectives and accreditation requirements are upheld in provider and client contracts. Ensuring network activities and services are provided in accordance with company objectives and state and federal law.
• Provides support to ensure  accreditation standards and processes for Connection Dental Network meet company, clients, providers and accreditation obligations.
• Recommends and implements network improvements to ensure the stability and integrity of the networks. Evaluates data and recommends corrective action such as enhancements or changes in PPO arrangements.
• Responsible for provider content management, including but not limited to, network website, social media presence, provider outreach and network-wide internal documents to ensure G.E.H.A brand standards are met, the Connection Dental Network messaging aligns with G.E.H.A’s overall direction and strategies.  Cross-functional interactions and alignment with the Marketing team and GSI are essential.  
• Assist in managing expenses and capital budgets for Provider Relations department.
• Manages network workflow, ensuring quality, quantity and uniformity goals are met for the Provider Relations teams and across the network.  
• Provides regular feedback that facilitates individual employee development. Holds direct reports accountable for producing quantity, quality, and timely results. Recommends hiring, promotion, termination, or reassignment of subordinates. Schedules and conduct performance reviews. Conduct meetings with employees to communicate organizational and departmental changes, as necessary.
• Responsible for supporting development in leaders in the team to sustain appropriate succession planning.

Knowledge, Skills, and Abilities

• Requires a bachelor’s degree in business, Health Care Administration, or a related field. Additional years of qualifying experience may be considered in lieu of formal education.
• Requires 5 years of experience in the dental industry, provider relations, which include 3 years of experience managing or leading a team.
• Must possess a successful record of collaborating with multiple teams and developing and deploying provider network strategies. 
• Must possess highly effective verbal and written communication skills to negotiate and resolve complex contracting issues, give directions, and resolve work issues. Requires the ability to work collaborative with cross-functional teams. 
• Ability to prioritize workflow and work independently.
• Must be able to thrive in a fast pace, changing environment, define problems, collect data, establish facts, and draw valid conclusions.
• Experience in developing a high performing team, developing a plan for teams to successfully achieve goals and leading teams through change.
• Requires working knowledge of Microsoft Office applications. 

• Office applications. 

Preferred Qualifications

• Experience with Lean principles and continuous improvement methodologies
• Experience with Salesforce
• Experience with content management and development
• Knowledge of dental terminology, CDT, dental procedures, and products

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges
• Incentive plan
• Health/Vision/Dental benefits effective day one
• 401(k) retirement plan:  company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution   
• Robust employee well-being program
• Paid Time Off
• Personal Community Enrichment Time
• Company-provided Basic Life and AD&D
• Company-provided Short-Term & Long-Term Disability
• Tuition Assistance Program

While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.

Please note that the salary information is a general guideline only.  G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The hiring range for this position is $100,845 - $127,575 USD. At G.E.H.A, the current maximum salary for this role is $142,155 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.

G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees.

G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles. 

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