California Senior Manager, Provider Management, DentaQuest

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

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.

Job Description:

Location: We support US flexible working arrangements in the contiguous 48 states.   

At Sun Life, we look for optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America

The opportunity:  

The Senior Manager, Provider Partners provides guidance and oversight to Provider Partners regarding benefit programs, policies and procedures. The position is also responsible for identifying and addressing network gaps, recognizing and implementing process improvement opportunities, and monitoring CAP performance. This position is responsible for mentoring and coaching 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 support 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.

  • Responsible for attendance and company approved time off for team members.

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

• Other duties as assigned

What you will bring with you:  

Required Qualifications:

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

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

• 5 years’ supervisory/management experience.

• Excellent verbal and written communication skills.

• Ability to work independently 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.

Preferred Qualifications:

• Supervisory/leadership experience.

• Experience in communicating with and training provider offices and customers.

• Experience in a managed care environment.

Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you.  

Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!  

Life is brighter when you work at Sun Life  

• Excellent benefits and wellness programs to support the three pillars of your well-being – mental, physical and financial – including generous vacation and sick time, market-leading paid family, parental and adoption leave, a partially-paid sabbatical program, medical plans, company paid life and AD&D insurance as well as disability programs and more  

• Retirement and Stock Purchase programs to help build and enhance your future financial security including a 401(k) plan with an employer-paid match as well as an employer-funded retirement account   

• A flexible work environment with a friendly, caring, collaborative and inclusive culture   

• Great Place to Work® Certified in Canada and the U.S.   

• Named as a “Top 10” employer by the Boston Globe's “Top Places to Work” two years running  

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.  

Salary Range: $70,600 - $105,900

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.

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter -for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more.  

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.   

#LI-remote    

Our Affirmative Action Program affirms our commitment to make reasonable accommodation to the known physical or mental limitation 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 thebrightside@sunlife.com to request an accommodation.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

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

Job Category:

Posting End Date:

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