Job Description
Job Title: Professional Services Reporting Specialist Number of Positions: 1 Location: Okemos, MI Location Specifics: Fully Remote Job Summary: Candidates must reside within a reasonable commuting distance of our Okemos, MI office for team meetings, collaborative sessions, and training. 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. Job Summary: Serves as liaison to other Delta Dental Plans, representing the Tri-State operation for new and existing DeltaUSA business activities; and monitors and audits provider network access and adequacy issues for Medicaid and Medicare business. Primary Job Responsibilities: Works closely with Sales, Legal and Compliance and Government Funded Programs division on the administration of Medicaid and Medicare business as it pertains to provider network requirements and network adequacy standards. Conducts monthly and quarterly network adequacy audits for Medicaid and Medicare groups as required by CMS. Develops departmental policies and procedures required for Medicaid and Medicare business. Assists with special projects as appointed by the department director. Assists in the development of recruitment strategies, researches, analyzes and generates various provider and group reports for DeltaUSA business to support provider network expansion or resolve disruption in the Tri-State territory, and orchestrates recruitment efforts based on the needs of internal and external customers. Develops and generates earnings and county group report queries for recruitment and retention of dentists, and trains staff on the use of reports generated. Develops a variety of documents, surveys, communications and mailings for DeltaUSA and Medicaid and Medicare business activity. Assists with NPF audits as needed and all tasks associated with the annual initiative. Administers Salesforce user support to Professional Services Representatives. Works with Salesforce Administrator and IT staff to resolve Provider data issues in Salesforce. Develops, generates and monitors a variety of reports from logged activities completed by the field representative. Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above. #LI-Remote Minimum Requirements: Position requires an associate's degree in business administration, healthcare administration, or a related field and four years of experience identifying, analyzing, or resolving issues based on policies and procedures. Will accept any suitable combination of education, training, or experience. Position requires knowledge of word processing and spreadsheet applications; strong verbal and written communication skills; strong analytical skills; the ability to manage multiple assignments with competing deadlines; and the ability to resolve 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. Delta Dental of Michigan, Ohio, and Indiana has been a dental benefits leader for more than 60 years, and today with our affiliates, we are one of the largest dental plan administrators in the country. It’s our mission to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by making investments that build healthy, smart, vibrant communities. We celebrate diverse thought and foster a culture where employees go All In – for the company, themselves, their colleagues and their communities. Employees are offered a comprehensive benefits package that includes medical, dental and vision coverage, short- and long-term disability, life insurance, 401(k) savings plans, flexible spending accounts, and tuition reimbursement or educational assistance. Employees are also eligible for annual incentive compensation based on annual business goals. Additionally, employees receive eight hours of paid volunteer time each year, access to an on-staff health coach and personal trainer, plus many other perks. Delta Dental is an Equal Opportunity Employer.
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