Dental Operations Manager

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: The Dental Operations Manager is responsible for managing, directing and supporting the dental operations for our Medi-Cal, Healthy Families and Medicare members. The director is also responsible for ensuring compliance with our Department of Health Services (DHS) and Healthy Families MRMIB contracts. Monitors Health Net's performance under its dental services contracts with the State. Ensures compliance with all aspects of the contracts. Oversees Health Net's dental administration functions that are performed by the designated third party administrator. Monitors administrator’s performance against contract. Acts as point person for provider relations and inquiries. Maintains and expands provider network through contract negotiations and execution. Works closely with Dental Director to ensure that the dental care provided meets the standards for acceptable dental care. Performs utilization review by reviewing claims and encounter data. Develops and implements policies and procedures for the dental plan. Assists in grievance resolution related to quality of care under the dental plan. Actively participates in plan grievance procedures under the dental plan. Makes recommendations as needed to HN management on ways to improve/enhance dental operations Education/Experience: College degree in Business preferred. Five to ten years managed care dental experience. Prior experience with negotiating provider contracts preferred. Location: Candidate must live in CA. Will require some travel. Pay Range: $107,700.00 - $199,300.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply To This Job