Manager Dental Benefits and Third-Party Payer Issues

Who We Are: It all starts with purpose.

We are a purpose-driven nonprofit with a dynamic staff culture.

With a meaningful purpose, motivated staff, and excellent benefits, working here will definitely have you smiling! The ADA's headquarters is located just steps from Chicago's Magnificent Mile and close to public transportation. With more than 400 colleagues, the ADA Staff are some of the most talented people in the Chicago, Washington D.C., and Maryland area.

We were named a Top Workplace by the Chicago Tribune in 2019 and 2021! Come join our team!

Job Responsibilities:

The Manager of Dental Benefits and Third-Party Payer Issues provides operational leadership for the ADA's Council on Dental Benefit Programs. The role oversees all aspects of the Association's dental benefits and third-party payer initiatives, including Council and program operations, policy development, and stakeholder engagement. It provides staff support for public and professional volunteer committees and oversees third-tier member service functions related to the Third-Party Payer Concierge Service.

Must Have:

• Bachelor's degree or experience in lieu of degree
• 5 years of experience (or 9 years in lieu of a degree) program management or operations in the healthcare, managed care, or insurance industry, including four years of experience in the dental industry
• Experience engaging with external organizations or payers to resolve issues
• Experience with direct experience in dental benefits administration or management
  
  
  
• Comprehensive understanding of dental benefit plan design, administration, and reimbursement methodologies
• Knowledge of claim adjudication processes, coordination of benefits, downcoding, bundling, and non-covered services policies
• Familiarity with provider network contracting, fee schedules, utilization management, and prior authorization practices
• Must have verbal communication, writing, analytical, facilitation, collaboration, presentation, a self-starter, results-focused skills
• Proficiency in M365 (MS Office)
• Travel twice per year, 1-3 nights per trip for attendance at CDBP or ADA meetings, industry conferences/events such as AADC, or other meetings as assigned
• Position may require before or after hours work and/or may require weekend work

Nice to Have:

• American Association of Dental Consultants (AADC) Certification or Dental Coding or Reimbursement Certification (e.g. Dental Coding Consultant or Dental Benefit Specialist)
• Certification in health or dental benefits administration, such as Certified Employee Benefit Specialist (CEBS), Health Insurance Associate (HIA)

Just a few of the benefits offered to employees:

• Promotes Work/Life Balance
• Hybrid Work Schedule (2-3 days from home)
• Health insurance/ dental reimbursement plan
• Ample Paid time off
• 401(k)
• Pension
• Flexible Spending Account
• Life insurance
• Tuition reimbursement
• Paid Parental Leave
• Pet Insurance
• Student Loan Refinance
• 2 days off to work at a charity event of your choice

The ADA values a variety of backgrounds and experiences and is committed to providing equal employment opportunities to qualified job candidates. The ADA is an equal opportunity employer of protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment in open positions without regard to race, ethnicity, gender, color, religion, sex, age, marital status, ancestry, citizenship, physical or mental disability, medical condition, veteran status or any other characteristic.

The American Dental Association is committed to providing reasonable accommodations for candidates with disabilities in our recruiting process. If you need any assistance or accommodations due to a disability, please let us know at recruiting@ada.org

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.