Payor Plan Manager
3 weeks ago
Overview
This position reports to the VP of Payor Relations. The Payor Plan Manager is responsible for the process of creating accurate payor plans in the Dentrix/Ascend PMS system, to be attached to patients and utilized by the practice teams. This role also oversees the daily operations of the patient eligibility process. This will include managing internal employees and possibly 3rd party vendors. The Payor Plan Manager will work closely with the Regional and Practice Managers to ensure the process allows for accurate treatment planning and applying accurate patient insurance benefits.
The Payor Plan Manager will load and maintain accurate fee schedules (UCR & Payor Fees), as well as run regular reporting to catch an inaccuracies of fee schedule attachment that may have occurred at the practice level.
Communicating and training practice teams on these processes to ensure compliance and a smooth workflow is key.
ResponsibilitiesEssential Duties and Responsibilities
Oversee the daily operations of the of the patient eligibility process to support practice teams. Manage the setup of insurance plans in the Dentrix/Ascend PMS system, to include the attachment of accurate fee schedules. Develop and implements protocols in collaboration with the VP of Payor Relations, Revenue Cycle Management, and Operations to support success. Maintains and enhances ongoing communication and coordination across departments to ensure accurate information and understanding of the information is delivered. Work with 3rd party vendors to grow the plan setup and move additional responsibilities to a centralized level (some plan setup items are currently happening at the practice level). Create tracking and reporting to support clean process and early identification or errors. Support efficient workflows, maintain ongoing tracking & reporting, hold teams and vendors accountable for accuracy, and have regular communication with all team members involved in the process. Establish and/or improve upon existing process to proactively load UCR and Payor Fee Schedules into the Dentrix/Ascend PMS system. Work directly with DSO contacts to request and load new yearly fee schedules in advance of 12/31 deadlines. Share updates and improvements with Regional Managers, Practice Teams and ROC. Collaborate with payors and Ascend team to improve upon eligibility process, plan setup, fee schedule setup, and reporting. Implement and monitor productivity standards for eligibility and plan setup team. Report productivity weekly to VP of Payor Relations. Manage and provide leadership to the eligibility and plan setup team that fosters a customer service attitude and positive, professional behaviors. Provide constructive feedback on performance and goals to eligibility and plan team members, as well as yearly performance reviews. Host weekly team meetings to keep eligibility and plan setup team members engaged and informed. Operate in compliance with all local, state, and Federal laws as well as Company policy and compliance standards. Other duties and responsibilities as assigned. QualificationsQualifications
Bachelor’s Degree or equivalent experience in the healthcare field preferred. 10+ years of related experience working in a dental practice, dental operations, or dental support profession preferred. Special consideration to applicants with relevant medical (or other healthcare industry) experience. Knowledge of Dentrix Ascend PMS system highly recommended. Understanding of dental insurance, patient dental benefits, plans and eligibility, dental claim understanding required.Ability to interpret third party payor benefits required. Demonstrated experience auditing and maintaining detailed tracking and reporting to monitor accuracy. Detail oriented with a high level of organization, analytical, and problem-solving skills. Excellent multi-tasker with ability to remain calm and professional in a fast-paced environment. Ability to work autonomously and efficiently within designated timeframes or deadlines. Communicates effectively orally and in writing. Promotes de-escalation in tense situations to keep teamwork as the primary focus. Proficient with Excel, Word, MS Teams, and Outlook necessary. To qualify for remote status, the right candidate must have a dedicated, distraction free home workspace, this is a full-time position and full attention needs to be on the job responsibilities during working hours. Schedule is flexible but must base hours around when to best support practice teams. Ability to effectively manage offsite/remote employees and run regular Video Teams meetings necessary.Certificates, Licenses, Registrations
N/A
Location
The position is based in the Waltham, MA Support Center with the ability to work remotely. To qualify for remote status, the right candidate must have a dedicated, distraction free home workspace, this is a full-time position and full attention needs to be on the job responsibilities during working hours. Schedule is flexible but must base hours around when to best support practices and manage team members productivity/performance. Some travel to Waltham for group meetings may be required.
-
Waltham, United States Upstream Bio Full timeUpstream Bio is developing innovative therapeutics in inflammation. We are a nimble company with solid financial backing that has raised $400M from high-quality investors. We are developing a monoclonal antibody targeting validated biology and are focused on our two Phase 2 studies in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) 2024. Our...
-
Waltham, United States Upstream Bio Full timeUpstream Bio is developing innovative therapeutics in inflammation. We are a nimble company with solid financial backing that has raised $400M from high-quality investors. We are developing a monoclonal antibody targeting validated biology and are focused on our two Phase 2 studies in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) 2024. Our...
-
Waltham, United States Upstream Bio Full timeUpstream Bio is developing innovative therapeutics in inflammation. We are a nimble company with solid financial backing that has raised $400M from high-quality investors. We are developing a monoclonal antibody targeting validated biology and are focused on our two Phase 2 studies in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) 2024. Our...
-
Waltham, United States Upstream Bio Full timeUpstream Bio is developing innovative therapeutics in inflammation. We are a nimble company with solid financial backing that has raised $400M from high-quality investors. We are developing a monoclonal antibody targeting validated biology and are focused on our two Phase 2 studies in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) 2024. Our...
-
Waltham, United States Upstream Bio Full timeUpstream Bio is developing innovative therapeutics in inflammation. We are a nimble company with solid financial backing that has raised $400M from high-quality investors. We are developing a monoclonal antibody targeting validated biology and are focused on our two Phase 2 studies in asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) 2024. Our...
-
Operations Manager
4 weeks ago
Waltham, United States Integrated Partners Full time**Job Summary**: **Responsibilities**: - Manage the day-to-day aspects of a financial planning practice - Maintain CRM including client info, client contact/calls, defined system flows, and activities to ensure integrity of database - Prepare all materials for client meetings including agendas, annual review reports, and filling out and preparing paperwork...
-
Sr. Manager, Financial Planning
3 weeks ago
Waltham, United States Sobi Full timeJob Description Sobi is currently seeking a Sr. Manager, Financial Planning & Analysis to join our Finance team. This position is responsible for forecasting, variance analysis, business partnering with non-finance personnel and maintenance and design improvements to our financial planning system. This occurs within a fast-paced and highly collaborative...
-
Paraplanner, Advanced Planning
2 months ago
Waltham, United States Commonwealth Financial Network Full timeOverview: If you’re looking for a high-energy, inclusive atmosphere and a company that understands the importance of work/life balance, Commonwealth is your match! From generous bonus and 401(k) programs to tuition reimbursement and flexible work schedules, Commonwealth is focused on helping its employees thrive in an environment suited to their needs. On...
-
Sr Director, Merchandise Planning
1 month ago
Waltham, United States Wolverine Worldwide Full time**Success Profile** Check out the top traits we're looking for and see if you have the right mix. * Collaboration * Consumer-Obsessed * Building an Inspiring Culture * Technological savvy * eCommerce Business Acumen "In my role, I am responsible for collaboration with all cross-functional partners to manage all aspects of the eCommerece business, including...
-
Sr Director, Merchandise Planning
3 days ago
Waltham, United States Wolverine Worldwide Full time**Success Profile** Check out the top traits we're looking for and see if you have the right mix. * Collaboration * Consumer-Obsessed * Building an Inspiring Culture * Technological savvy * eCommerce Business Acumen "In my role, I am responsible for collaboration with all cross-functional partners to manage all aspects of the eCommerece business, including...
-
Analyst, Capital Project Planning
3 weeks ago
Waltham, United States National Grid Full time**About us**: Superpowered. Meaningful work. Human impact. A story we’re proud to tell. This is what matters to us at National Grid. In a world of complexity and unanswered questions, there is one thing we’re certain about: the power of our people. The magnitude of our purpose—to build a more affordable, cleaner and sustainable energy future—means we...
-
Engineer, Electrical Planning and Design
1 week ago
Waltham, United States National Grid plc Full timePress Tab to Move to Skip to Content Link Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Engineer, Electrical Planning and Design Location: Waltham, MA, US, 02451 Hopedale, MA, US, 01747 Northboro, MA, US, 01532 Division: Job Type: Requisition Number: 55307 Department: Electricity Transmission - Operations Job...
-
Associate Director, Supply Chain Planning
2 months ago
Waltham, United States Dyne Therapeutics Full timeCompany Overview: Dyne Therapeutics is a clinical-stage muscle disease company focused on advancing innovative life-transforming therapeutics for people living with genetically driven diseases. With its proprietary FORCE™ platform, Dyne is developing modern oligonucleotide therapeutics that are designed to overcome limitations in delivery to muscle...
-
Director, Plan to Perform Transformation
3 days ago
Waltham, United States National Grid Full time**About us**: Every day we deliver safe and secure energy to homes, communities, and businesses. We are there when people need us the most. We connect people to the energy they need for the lives they live. The pace of change in society and our industry is accelerating and our expertise and track record puts us in an unparalleled position to shape the...
-
Associate Director, Supply Chain Planning
3 weeks ago
Waltham, Massachusetts, United States Dyne Therapeutics Full timeCompany Overview:Dyne Therapeutics is a clinical-stage muscle disease company focused on advancing innovative life-transforming therapeutics for people living with genetically driven diseases. With its proprietary FORCETM platform, Dyne is developing modern oligonucleotide therapeutics that are designed to overcome limitations in delivery to muscle tissue....
-
DigitalIT Supply Chain Planning Specialist
1 month ago
Waltham, United States Abcam Plc Full timeJob Description We are seeking a talented Supply Chain Planning Specialist to join our team in Waltham, MA. In this role, you will play a crucial part in supporting the enhancement, validation, and maintenance of various supply chain planning applications. Working closely with business colleagues and technology partners, you will help drive new software...
-
Digital/IT Supply Chain Planning Specialist
3 weeks ago
Waltham, United States Abcam Plc Full timeJob DescriptionJob DescriptionCompany DescriptionFor over 20 years, Abcam has been providing tools the scientific community needs to enable faster breakthroughs in critical areas like cancer, neurological disorders, infectious diseases, and metabolic disorders.We believe that to continue making progress, we need to work together in new ways. We need your own...
-
Digital/IT Supply Chain Planning Specialist
2 weeks ago
Waltham, United States Abcam Plc Full timeJob DescriptionJob DescriptionCompany DescriptionFor over 20 years, Abcam has been providing tools the scientific community needs to enable faster breakthroughs in critical areas like cancer, neurological disorders, infectious diseases, and metabolic disorders.We believe that to continue making progress, we need to work together in new ways. We need your own...
-
Lead Planner, Capital Project Planning
2 days ago
Waltham, United States National Grid Full time**About us**: **National Grid is hiring a Lead Planner for our New England Electric Contracts and Commercial department in Waltham, MA. This is a hybrid position.** Superpowered. Meaningful work. Human impact. A story we’re proud to tell. This is what matters to us at National Grid. In a world of complexity and unanswered questions, there is one thing...
-
Waltham, United States National Grid plc Full timePress Tab to Move to Skip to Content Link Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: Lead Engineer, Electrical Planning and Design Location: Waltham, MA, US, 02451 Division: Job Type: Requisition Number: 55483 Department: Electricity Transmission - Operations Job Function: Engineering About us National...
