Job Description
Position Summary:
Responsible for leading, researching, designing, developing, and recommending a strategic plan/program(s) to ensure the organization's "readiness to launch" a comprehensive and competitive response to government program initiatives including Medicaid, Medicare Advantage, and the (State) Children's Health Insurance Programs (CHIP).
Essential Duties:
- Works with the executive team to formulate a business plan and strategy to implement government program capabilities for Delta Dental of Rhode Island and Altus Dental,
- Ensures all current state of readiness gaps in processing capabilities, staffing, and compliance are identified and sufficiently addressed prior to launch,
- Researches and specifies all federal and state regulatory reporting requirements and ensures reports are accurate and delivered within specified timeframes,
- Monitors all contractual specifications and ensures compliance,
- Prepares accurate reports for leadership review and ensures submission within specified timeframes,
- Works with the executive and sales teams to develop partnership strategies and identify opportunities and areas of concern with each relationship,
- Represents the company on relevant association and government related committees such as DDPA, MSDA, and others,
- Creates initial and ongoing landscape threat analysis,
- Monitors competitors and identifies potential collaborators,
- Assesses both commercial and government retiree market potential and strategy to address this population,
- Analyzes and summarizes relevant research in clear and concise formats with accompanying recommendations,
- Initiates external contacts required to foster collaboration and partnerships; Develops and delivers professional presentations to internal and external stakeholders,
- Serves as the organization's internal subject matter expert in government programs and stays abreast of new requirements and developments in the this space; Works with the executive team and external firms to continuously monitor legislative and regulatory activity and provide summarized analysis of research performed,
- Works with the Professional Relations team(s) on development of proper contracting and credentialing procedures.
Qualifications:
- 4-year degree in relevant field of study
- 10 or more year's experience in the insurance sector
- 5 or more years leading government programs in the insurance sector
- Solid knowledge of insurance principles
- Proven tract record of strategic, multi-disciplinary thinking
Type: Full-time
About
Delta Dental of Rhode Island
Delta Dental of Rhode Island is the state’s leading dental insurer, administering dental benefits for nearly 613,000 members. Headquartered in Providence, we remain a symbol of strength and stability in the local dental insurance arena.
Our strength is evidenced by the fact that 96% of our customers said they were satisfied or very satisfied with our overall performance last year. And, 98% said they were satisfied with the quality of their treatment.
For more than 50 years, Delta Dental has provided affordable dental insurance to employers, individuals and families across the country. As the nation’s largest, most experienced dental benefits carrier, Delta Dental serves more than 73 million Americans with dental coverage. Delta Dental provides dental coverage to more than 139,000 groups nationwide.