Roe Macdonald Email & Phone Number

Plymouth Meeting, Pa.

Dental Network Liaison Team Lead >Provide leadership to a team of Dental Liaison Specialist >positioned as the subject matter expert for Aetna’s line of dental products. >responsibility for achieving territory goals and metrics >Develop and educate staff.>Act as Liaison with the Dentists and responsible for overall maintenance of specific territory.>Act as functional subject matter expert>Negotiation of contract language and provider compensation.>Timely response to correspondence from Provider offices.>Cost of CareDental Network Liaison >Act as Liaison with the Primary Care Dentists and Specialists for the State of NJ. >Maintain territory and manage Network>Negotiation of contract language and provider compensation>Interact with external providers regarding routine care situations.>Developed very good relationship with our provider network. Network Support Team Lead Managed 10-15 people in various positions, including Grievance and Appeals, Contract Team, Network Specialists team and Administrative Unit.Worked through integration of Aetna/Prudential - this includes but not limited to check workflow, compensation reviews, complaint policy, and other issues integrating the multiple systems and companies merged (US Healthcare, Aetna, Prudential, NIAL Care. Network Specialist System maintenanceGrievance and Appeals Analyst Responsible for handling member and provider complaints