Senior Manager, Provider Engagement, DentaQuest - South Carolina

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

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.

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.

Candidates must reside in the state of South Carolina.

The opportunity:

The Senior Provider Network Manager provides guidance and oversight to Provider Partners regarding benefit programs, policies, and procedures. The position handles identifying and addressing network gaps, recognizing and implementing process improvement opportunities, and monitoring CAP performance. This position mentors and coaches their team in provider recruitment and engagement. In addition to managing staff, the role may also have responsibility for covering larger or more complex situations and markets.

How you will contribute:

• Manage and Guide provider engagement staff

• Ensure provider engagement staff recruits providers within cost and access goals

• Authorize and negotiate special deals

• Develop strategic action plan to address network gaps

• Develop provider education curriculum and approach

• Cover more markets or highly complex markets

• Organize amendment and recruitment projects

• Develop project plans, internal/external reports, and ensure deliverables are met

• Identify and coordinate implementation of quality/cost improvements

• Manage reporting process to identify and modify provider outliers

• Provide cross-market aid as needed

• Analyze and monitor provider performance reports

• Participate in and often present during client, organized dentistry and key stakeholder meetings/events

• Identify continuous improvement opportunities

• Manage CAP office performance

• Coordinate and implement appropriate performance management strategies for team members to include:

• Assist in the hiring process, including interviewing candidates.

• Assist, train and motivate team members.

• Evaluate and measure effectiveness of team members.

• Assist in preparation of performance and wage evaluations in accordance with company policy.

• Manages attendance and company-approved time off for team members.

• Participate in the drive and implementation of Performance Improvement Plans and performance management initiatives.

• Other duties as assigned

What you will bring with you:

• Bachelor’s degree in Business, Healthcare Administration (or related field) or equivalent, relevant experience.

• 5 years of experience in healthcare practice or managed care environment.

• 5 years’ supervisory/management experience preferred

• Experience in a managed care environment preferred

• Excellent verbal and written communication skills.

• Ability to work alone and as part of a team.

• Knowledge of Microsoft Office.

• Proven problem-solving skills.

• Problem-solving and training experience.

• Ability to make sound judgment conclusions based on data available with minimal oversight.

• Up to 20% of travel as needed.

Salary:

Salary Range: $78,100 - $117,200
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

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We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.  We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate.  We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program.  Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account.  Enjoy a flexible, inclusive and collaborative work environment that supports career growth.  We’re proud to be recognized in our communities as a top employer.  Proudly Great Place to Work® Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.  Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodations to the known physical or mental limitations 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 [email protected] to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

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.