Supervisor, Vision Program Operations

Remote Opportunity: 0

Requisition Number: 2836

Position Title: Supervisor, Vision Claim Administration

External Description:

The Vision Team Supervisor leads the activities necessary for achieving superior operational performance and process excellence in customer service, claims process, prior authorization determination, C&G&A processing and client reporting. This position meets departmental goals by guiding and directing the activities of the team; ensures that appropriate development, training, and performance management of these resources takes place. Ensures DentaQuest Vision program is seen as a differentiator in the market place.

PRIMARY JOB RESPONSIBILITIES:

• Accomplish departmental goals by providing leadership and directing activities of the vision production staff and by proactively communicating to director, issues which may prevent accomplishment of departmental goals.
• Supervising staffing of vision team resources by working with statistical data from call center, claims, prior authorization and C&G&A reports and team productivity, when appropriate.
• Assess call quality produced by employees and the team by monitoring telephone calls and reviewing written correspondence.
• Assess call monitoring and take the actions as required to improve or sustain performance.
• Develop action planning for performance improvement by analyzing monthly reports and other observed trends.
• Ensure all regular and advanced claims are processed within client contractual requirements.
• Provide team of subject matter experts in benefits and claim processing for all clients and products within the DentaQuest portfolio.
• Serve as an expert as to claim processing, payment compliance, turnaround times, interest requirements and all other payment related processes.
• Oversee claim payment research and Lead small or large scale claim resolution and research projects.
• Provide recommendations around financial solutions following claim payment research.
• Lead the timely, accurate and efficient processing of complex claims.
• Ensure prior authorizations are processed to meet client, state and federal requirements.
• Participate in client audits and develop and implement client corrective action plans.
• Ensure departmental metrics are achieved by team members.
• Manage Altiris tickets and ensure appropriate language, attention, and turnaround times exist to appropriately address departmental needs.
• Develop innovative ways to motivate the staff.
• Foster an environment of teamwork by participating in and leading teambuilding activities.
• Resolve issues in accordance with DentaQuest’s internal policies, client contracts, and state and federal regulations.
• Prepare reports and conduct data analysis for client meetings and presentations.
• Identify and create efficiencies.
• Implementation and supervision of ongoing training program for all new and existing team members in the department.
• Assist in the hiring process, including interviewing candidates, designing job descriptions, drafting advertisements and promoting the organization to external applicants.
• Complete all employee management duties, including but not limited to, hiring, training, terminations, corrective active plans, reward and recognition, preparation and presentation of performance evaluations assuring compliance with DentaQuest’s policies, while creating an environment of performance and operational excellence
• Conduct daily, weekly and/or monthly staff meetings Leads at a supervisor level including, but not limited to, attendance and company approved time off for department team members, employee relations, training, corporate initiatives and coaching.
• Other duties as needed or required.

JOB QUALIFICATIONS:

Required:

• Bachelor’s degree required.
• 2 years’ supervisory experience working in a fast paced environment.
• Knowledge of claims life cycle.
• Excellent analytical and problem solving skills.
• Strong computer skills including Microsoft Office applications, and general reporting software.
• Ability to present to professionals – clients, colleagues, senior leaders.
• Excellent math capabilities; including the ability to analyze and organize data.
• Strong attention to detail.
• Ability to make appropriate decisions.
• Excellent organizational skills.
• Operate with minimal direction
• Excellent communication skills: written, verbal and interpersonal.
• Ability to work well with others at all levels of the organization.
• Ability to work under pressure.
• Ability to identify and escalate critical conditions.
• Strong aptitude for learning new technology applications.
• Ability to work in excess of 40 hours per week as needed or required to meet business needs.
• Required to attend additional training as requested/deemed necessary.

Preferred:

• Experience with insurance and/or service industry a plus.

PHYSICAL DEMANDS: Incumbent must be able to communicate effectively. Requires overall light physical effort (up to 25lbs.) Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer). Ability to travel or move about within and outside serviced facilities required. Incumbent works primarily in either a private or shared office environment.

City: Milwaukee

State: Wisconsin

Community / Marketing Title: Supervisor, Vision Program Operations

Company Profile:

At DentaQuest, we believe that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system – from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.

Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it. 

To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and delivering measurable outcomes for the people we serve.

The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.

Location_formattedLocationLong: Milwaukee, Wisconsin US

CountryEEOText_Description: Equal Employment Opportunity Statement: DentaQuest is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, sex, age, disability, marital status, or sexual orientation.