Payer Relations Manager

Overview

MB2 Dental, a first-of-its-kind Dental Partnership Organization (DPO) founded in 2007, is seeking a Payer Relations Manager to join our team in Carrollton, TX. This is an excellent opportunity to work in a highly collaborative environment while independently managing multiple tasks and responsibilities.

• Negotiate and maintain the best terms and compensation with dental payers for MB2 Dental (MB2) affiliated offices. Responsibilities include optimizing dental plan participation, navigating rental (lease) networks, serving as a key liaison between MB2 offices and payers, and providing strategic payer advice to the offices, Credentialing, and Central Business Office.
• Optimize existing payer participation by negotiating all contract terms and compensation, and pursuing plan membership on a regular cadence.
• Review payer agreements to identify and negotiate language that minimizes risk to providers.
• Understand the differences between direct and indirect payer relationships (network leases) and their implications for reimbursement.
• Prospect new payer network offerings and present analysis of strengths and weaknesses to the offices for consideration.
• Analyze payers with inferior fees and/or membership and present findings to offices for TERM consideration.
• Serve as primary MB2 contact with assigned (national) payers to resolve high-impact issues.
• Serve as subject matter expert and information resource on assigned payers for MB2 internal audiences, including understanding carrier guidelines, contractual terms, and claims processes.
• Actively manage assigned payer relationships, including hosting regularly scheduled reviews to discuss opportunities for increased partnership and reimbursement.
• Support internal departments, such as RCO and Credentialing, in researching and resolving payer-related issues that impact multiple practices.
• Support implementation of operational efficiencies, such as EDI, EFT, ERA, web portals, and delegated credentialing.
• Coordinate patient grievance resolution with the Compliance Department as needed.
• Monitor state and federal legislation that affects payer products and reimbursement.
• Perform other related duties, as assigned.

• Analytical Skills
  • Gather and analyze information skillfully with the ability to create action plans.
  • Prospecting: identify viable growth opportunities through data collection and analysis.
  • Think strategically and communicate recommendations to senior management.
  • Project revenue streams, conduct post-launch profitability analysis, and draw conclusions with recommendations.
• Relationship Management Skills
  • Interpersonal skills: develop productive business relationships inside and outside MB2 Dental.
  • Negotiation skills: experienced negotiator, able to reach mutually beneficial agreements.
• Communication Skills
  • Language: read, write, and speak English fluently.
  • Oral: speaks clearly and persuasively; effectively presents information.
  • Written: writes professional business correspondence; presents numerical data effectively.
  • Presentation: effective presentation skills with the ability to present to small groups of people.
• Organizational Skills
  • Initiative: self-motivated, requiring minimal supervision while working remotely.
  • Time Management: organize and prioritize workload and execute tasks in a timely manner.
  • Administrative
    
    Skills:
    
    detail-oriented; pays close attention to accuracy.
• Computer Skills
  • Strong computer/PC skills.
  • Software: working knowledge of Microsoft Office, including Outlook, Word, and PowerPoint.
  • Software: advanced knowledge of Microsoft Excel, including the ability to create, manipulate, analyze, and interpret spreadsheets.

• A bachelor’s degree is desirable.
• Understanding of all dental benefit models, including FFS, Indemnity, PPO, EPO, DHMO, Discount, Medicaid, and Medicare Advantage structures.
• Understanding of rental / leased networks.
• 10 years of dental industry experience.
• Two to five years of dental provider experience is required; experience with dental plans is a plus.
• An equivalent combination of education and experience is considered.

• Limited travel — 10-15% of the time.
• Minimal overnight travel required.

MB2 Dental Solutions, LLC is an equal opportunity employer.