At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.
At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.
Position Description
Leads internal and external implementations and projects associated with government program business. Serves as a liaison and subject matter expert between compliance, business, and information technology feature teams to implement system changes related to government program compliance and business needs.
Primary Job Responsibilities:
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Partners with key business, information technology, and compliance stakeholders to identify and implement system and process changes related to government program requirements.
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Participates in activities related to bids, proposals, and opportunities for government program business.
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Plans projects, implementations, quality control, and workflows within the government programs services team.
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Partners with other departments regarding workflow, processes, and trends for all areas of government programs to ensure regulatory compliance.
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Evaluates, recommends, and oversees the implementation of new Medicare Advantage, Medicaid, and Dual program clients on behalf of Delta Dental of Michigan, including third party administrator business, as well as relevant changes to existing clients.
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Oversees and tracks the use and delivery of government program data and reporting, including eligibility, encounter data, and client reports to maintain internal and external government program compliance oversight requirements.
Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
#LI-Hybrid
Minimum Requirements:
Position requires a bachelor’s degree in business administration, healthcare administration, or a related field and seven years of experience in operational administration, servicing group health contracts, or project management. Previous experience servicing Medicaid, Medicare Advantage, or dual programs is preferred. Will accept any suitable combination of education, training, or experience.
Position requires knowledge of the health insurance industry; advanced knowledge of word processing and spreadsheet applications; strong verbal and written communication skills; strong analytical skills; strong interpersonal skills; the ability to work independently and as part of a team; the ability to manage multiple projects with competing deadlines; and the ability to solve complex problems using independent judgment.
The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.
