The Manager of Payment Rules & Outcomes is a key strategic leader in managing Delta Dental's health care industry rule practices, rule architecture, business capabilities, and administration of clinical and non-clinical policies to ensure quality outcomes and accurate payment.
Requirements
- Oversees business and clinical policy administrative rules and business 'ownership' for the tool(s) enabling claim or clinical outcome rules
- Leads a team of Outcome Rules Analysts that work cross-functionally to ensure Delta Dental has the right monitoring and controls in place to continuously and proactively evaluate rules in production
- Develops and maintains a comprehensive approach to analysis and reporting of outcome rule performance, trends and opportunities
Benefits
- Competitive base and incentive pay
- 401(k) with robust matching and non-matching contributions
- Rich medical & pharmacy benefits
- 100% employer-paid dental and vision benefits
- Holistic wellbeing program with deep financial incentives
- Generous paid time off plus 12 paid holidays and your birthday off
- Culture of growth and learning: career development; tuition reimbursement; recognition program
- Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
- Social responsibility and volunteer opportunities
- Employee discount program
