Administrator, Professional Relations
CurrentWork closely with Sales, Legal and Compliance and Government Funded Programs division on the administration of Medicaid/Medicare business as it pertains to provider network requirements and issues.Conduct monthly and quarterly network adequacy audits for Medicaid and Medicare groups as required for CMS. Develop departmental policy and procedure required for Medicaid/Medicare business.In addition, network recruitment support for field staff in 3 states Delta Dental administers; create technical reports for field staff use to recruit dentists into dental networks; liaison with fellow recruiters and Professional Services management with sister Deltas nationwide; liaison with tristate Sales staff with network needs, issues and developing recruitment strategies for book of business; assist with development and management of yearly recruitment strategies. Responsible for year-end verification and reporting on network access adequacy and credentialing performance guarantee standards were met for several Fortune 500 companies we administer benefits for. Department contact on use of contact management system, SalesForce, for use by field staff. Draft a variety of documents for Sales such as recruitment letters, network expansion progress reports, bid responses specific to recruitment activity, and a variety of unique letters to dentists.