Lead Dental Network Specialist

Emblem Health New York , NY 10007

Posted 2 months ago

Initiates and leads activities related to the administration, monitoring, and oversight of the Commercial EmblemHealth Dental PPO Provider Networks. Oversight of the integrity of the Fastrak provider file, compose, support and facilitate Credentialing compliance and protocols, establish and maintain Quality Assurance matrix for Service and Clinical Complaints, and provide guidance for member and dental provider resolutions. Interdepartmental liaison for project management and maintain open communication. Provides leadership to the department to ensure that projects and departmental objectives are achieved with a sense of urgency. Will also be maintaining additional responsibilities for a Network Specialist that was not replaced. This includes, but is not limited to, maintaining the dental Fastrak and Access databases, processing dental provider applications, scanning for disaster recovery (Softheon web based program), filing and preparation for trade shows.


  • Initiates and leads activities related to the administration, monitoring, and oversight of all dental network activities; develops and implements recruitment strategies for geo-access and sales support, contracts and conducts PR visits weekly. Directs, supervises, and provides weekly team huddles and as needed training for staff as well as provide positive leadership for staff's professional growth.

  • Works closely with all departments to identify and resolve systemic issues to provide support necessary to resolve such issues to reinforce provider/member retention and growth goals. Also collaborates to produce and verify data needed to efficiently pay dental claims and resolve service/clinical related member/provider issues.

  • Maintain additional responsibilities for a Network Specialist that was not replaced. This includes, but is not limited to, maintaining the dental Fastrak and Access databases, processing dental provider applications, scanning for disaster recovery (Softheon web based program), filing and preparation for trade shows.

  • As relationship manager for the credentialing vendor-Initiates and leads activities related to the credentialing process, and participates in Due Diligence activities to assure a dental network of high quality and integrity. Maintains Quality Assurance Matrix of providers- clinical and service related issues.

  • Initiates and manages projects to support dental product reliability and up to date communication i.e. web site, provider manuals, orientation materials, recruitment, contract initiatives.

  • Develops and maintains departmental data bases to support analytical reporting needs.

  • Volunteers on behalf of EH/GHI on NADP various workgroups. Identifies, oversees and participates in key Dental trade conferences.

  • Supports Internal audits from SOX & SAS teams.

  • Support Sales and Account Management requirements for commercial dental PPO products.

  • Regular attendance is an essential function of the job. Performs other duties as assigned or required.


  • College Degree

  • 5 or more years of experience in managed care/health care with minimum 5 years in ancillary programs. Dental benefits background preferred

  • 5 or more years clinical experience in a dental setting required

  • Knowledge of the health care industry and health care products required

  • Understanding of dental provider credentialing/contracting and dental claims systems required

  • Familiarity with dental provider community required

  • Knowledge of dental network models, laws, and regulations required

Additional Information

  • Requisition ID: 1901U

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Communications Lead Specialist

Deloitte & Touche L.L.P.

Posted 1 week ago

VIEW JOBS 10/4/2019 12:00:00 AM 2020-01-02T00:00 Communications Lead Specialist: Deloitte's Green Dot Agency Deloitte is looking for an internal communications professional with strong writing skills to join our in-house agency delivering innovative, high-impact communication campaigns and assets. In this role, you'll write and edit relevant, engaging copy that helps drive engagement of our leadership and professionals around key marketing campaigns. Working closely with the Communications senior manager, you'll collaborate with designers, digital producers, project managers, account managers and strategic marketers to create assets that will ultimately build the Deloitte brand by driving key messages from our marketing efforts with our internal audiences. The goal of these internal marketing efforts is to deliver key marketplace messages to internal audiences to enhance client conversations, and/or grow employee engagement as Brand Ambassadors. The initial focus for this role will be on supporting industry. If you thrive in a fast-paced environment, juggling multiple priorities at once, submit your resume today. Work you'll do * Collaborate with manager/sr. manager copywriters to conceptualize, write, and edit campaign assets including articles, web copy, emails, invitations, scripts, social media, and other internally focused collateral * Collaborate with designers to develop creative concepts for assets * Proofread materials for colleagues and provide quality control * Understand and translate Deloitte brand and style guidelines into a clear, confident, and human voice * Translate creative briefs into understandable and compelling assets that enhance communication, persuade readers, and distinguish the Deloitte brand; factor in internal stakeholder feedback, legal guidelines, and other requirements * Collaborate with campaign managers, designers, and digital producers to develop innovative assets on time and on budget * Participate in messaging and strategy sessions with Agency colleagues, strategic marketing planners and/or subject matter experts, providing input on creative assets for internal communication plans * Potential may also exist to provide support for select global marketing initiatives with internal communications components through Deloitte's global network of Member Firms * Manage deadlines for multiple projects simultaneously * Identify and recommend creative ideas that will deliver on campaign goals The team Deloitte's Communications team in the Green Dot Agency provides value to the U.S. Firms and contributions to Global Member Firms by delivering innovative communications strategies and approaches for internal and external audiences. The team brings together creative and technology skills, business insights, and industry best practices to develop creative assets that inspire and engage our professionals. It also executes with agility and measurable performance through best-of-breed solutions, centralization of key information and operations, and optimization of data, tools, people and process. From concept to execution, we help our leaders reach their audience and achieve a consistent standard of excellence using proven communication methodologies. Qualifications Required: * 5+ years of writing/editing/proofreading experience in corporate communications, journalism, publishing, public relations, marketing or related field. Writing sample required. * Conceptual, creative thinker with a passion for writing, story-telling, and the willingness to learn from others * Ability to structure and conduct interviews and other fact-finding research efforts and synthesize findings into key points * Strong project management and organizational skills * Comfortable in a fast-paced, flexing environment * Excellent interpersonal skills * High attention to detail and accuracy * Bachelor's degree in Communications, or related field * Preferred locations - Atlanta; Boston; Chicago; Tri-State (NY, NJ, CT); Washington DC How you'll grow At Deloitte, our professional development plan focuses on helping people at every level of their career to identify and use their strengths to do their best work every day. From entry-level employees to senior leaders, we believe there's always room to learn. In this exciting and challenging role, you'll gain first-hand insights into technical skills, critical professional behaviors, standards, and mindsets to help you expand on your previous experience, knowledge and skills. You'll work with a wide variety of talented strategic leaders and learn how to develop, implement, and measure innovative strategies, tackle real-world business issues head-on, and experience what it's like to be a part of our work culture. We offer opportunities to help sharpen skills in addition to hands-on experience in the global, fast-changing business world. From on-the-job learning experiences to formal development programs at Deloitte University, our professionals have a variety of opportunities to continue to grow throughout their career. Explore Deloitte University, The Leadership Center. Benefits At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you. Deloitte's culture Inclusion is a major part of how we lead. It invites authenticity, leverages our diversity, and fosters well-being. We seek out and involve individuals with diverse experiences and backgrounds because we know how critical this can be in making an impact that matters to our clients and our people. Learn more about Life at Deloitte. Corporate citizenship Deloitte is led by a purpose: to make an impact that matters. This purpose defines who we are and extends to relationships with our clients, our people and our communities. We drive impact through our signature national programs: education and veterans, and through pro bono and other key programs such as board service opportunities and Impact Day. Learn more about Deloitte's impact on the world. Recruiter tips We want job seekers exploring opportunities at Deloitte to feel prepared and confident. To help you with your interview, we suggest that you do your research: know some background about the organization and the business area you're applying to. We also suggest that you brush up on your interviewing skills and practice discussing your experience and job history with a family member, friend, or mentor. Check out recruiting tips from Deloitte professionals to help you prepare. As used in this posting, "Deloitte" means Deloitte Services LP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law. Requisition code: E20NATSSPLGO045-CL4 * * * * * * Deloitte & Touche L.L.P. New York NY

Lead Dental Network Specialist

Emblem Health