Oregon Dental Service
Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
Moda Health is seeking a Supervisor in our Dental Professional Relations department. This position oversees the entire Delta Dental of Oregon and Alaska, ODS OHP, and The Children’s Program provider networks; oversight includes recruiting/retention, provider relationships, contracting, sanctions, Facets configuration, NPF updates and maintenance; Primary point of contact for Delta Dental member company correspondence regarding out of state claims processing, dental benefits and best practices; attends DDPA sponsored events and is a member of the DDPA Professional Relations Advisory Group; ensures daily department operational tasks are completed including but not limited to provider contract setup, phone inquiries and oversight of DPR queues in Facets workflow..
1. Oversees the implementation of the Maximum Plan Allowance (MPA), PPO and OHP fee schedules, including the maintenance and uploads to the filed fee system.
2. Monitors provider information uploads and troubleshoots data inconsistencies between NPF and Facets.
3. Manages the commercial dental (Premier and PPO) and Oregon Health Plan dental networks, and other relationships necessary for the expansion of dental products.
4. Liaison between dental claims, dental customer service, credentialing, actuarial, benefit programming, sales & services and accounting departments. Provides assistance and feedback and attends meetings as applicable.
5. Resolve all escalated provider concerns.
6. Supervises staff giving daily work direction, vacation scheduling, monitoring attendance, performance reviews, and hiring and training new employees.
7. Represents dental professional relations department at company meetings, both internally and externally at functions such as trade shows, association meetings and provider workshops.
8. Directs the educational process through workshops, newsletters and on-site visits.
9. Management of recurring projects and deliverables such as the annual Directory Accuracy survey, monthly provider directory updates and network reports.
10. Coordinates provider communication through various channels (Dental Office Update, website, workshops, etc.) to introduce new policies, explain existing policies and request feedback for process improvement in conducting our business with provider offices.
11. Assist with recruitment of network providers including out of state emergency referrals.
12. Additional tasks/projects as assigned.
Are you ready to be a betterist?
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
1. Bachelor’s degree or equivalent.
2. 1-2 years’ experience in Professional Relations preferably as a PR Specialist or related field.
3. 2-4 years proven experience as a supervisor or relevant role.
4. 1-2 years dental claims processing or dental customer service experience.
5. Strong verbal, written, and interpersonal communication skills.
6. Possess analytical, problem solving and detail oriented skills.
7. PC proficiency with Microsoft Office applications.
8. Ability to work well under pressure, work with frequent interruptions, and shifting priorities.
9. Ability to come into work on time and on a daily basis.
10. Maintain confidentiality and project a professional business image.
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Health plans in Oregon, Washington and Alaska provided by Moda Health Plan, Inc. Dental plans in Oregon provided by Oregon Dental Service. Dental plans in Alaska provided by Oregon Dental Service dba Delta Dental of Alaska.
Oregon Dental Service
Website : http://www.odshealthplans.com
At Moda Health, we’re passionate about helping you on your journey to be better. We know that dealing with health concerns can be tough – and that it is a juggling act to fit in healthy choices every day. That’s what we’re here for. We’ll be your guide, your supporter, your fan club and your partner ready to help you every step of the way.