For nearly 40 years, Great Expressions Dental Centers (GEDC) has been a leader in providing preventative dental care, orthodontics and specialty care with 275+ local offices in nine states: Connecticut, Florida, Georgia, Massachusetts, Michigan, New Jersey, New York, Ohio, and Texas! One of the largest privately owned Dental Support Organizations in the United States, GEDC is consistently recognized for contributions to improving oral health through quality and safety initiatives, affordable dental care services, patient convenience, research and more. For more information, go to www.greatexpressions.com.
The Payer Relations Financial Analyst (seated in Southfield, MI and not a remote role) is accountable for working with the VP of Payer Relations to support all aspects of payer contracting strategies for Great Expressions Dental Centers (GEDC) that support revenue growth.
Key Responsibilities:
Build and maintain payer analytics capability to benchmark utilization and reimbursement levels across its 255-office network
Assist with payer contract negotiations renewals and renegotiations
Work with outside consultants and contracted third-parties with respect to payer relations
Thoroughly analyze and review rates and utilization in order to drive mutually beneficial outcomes for dental patients and providers
Analyze fee schedules by specialty and code relative to historical company utilization and industry comps
Track contracts and anniversary dates to ensure annual rates are implemented correctly and on time
Quantify rate impacts during negotiations and monitor ongoing utilization and expected fee changes
Assist in developing and maintaining appropriate policies, procedures, and controls for dental contracts and payer contracting activity
Build large data models to forecast and monitor payer rates by code
Interact/communicate with payers, keep a record of conversations with payers, schedule periodic phone calls and keep payer contact list updated
Resolve escalated issues with payers
Run and distribute revenue, impact analysis and other reports
Audit invoices from consultants and submit for payment
Other duties as assigned
Analytical ability and experience managing large data sets
Track record of success working in an environment of collaboration, transparency, mutual respect, and passion for excellence and innovation
Must be able to communicate and work effectively with all levels of employees and management
Strong organizational, project planning and project management skills are required
Proven ability to translate high-level business requirements into an operational product/service
Excellent financial and business acumen
Experience in healthcare is preferred, but not required
Education & Experience:
Bachelor's degree required, preferably in a quantitative field; MBA or advanced degree a plus
2-3 years of experience, preferably with a DSO (Dental service Organization) or a dental payer
Advanced Excel skills are a must
Strong organizational skills, accuracy and attention to detail
High level of maturity, personal initiative, and sound judgment
Strong work ethic
Dental experience and a knowledge of CDT codes and dental terminology is a plus
Dental EHR system experience is a plus
ID: 2020-19272
Street: 29777 Telegraph Road, Suite 3000