Overview

Dental Care Alliance’s mission is to advance the practice of dentistry by partnering with and supporting dental professionals to create a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA currently supports over 400 allied practices and supports over 900 dentists across over 20 States. DCA’s allied practices represent all dental specialties and treat patients under more than 150 brand names.

Dental Care Alliance is currently seeking a Senior Insurance Payer Analyst to execute strategic planning for insurance plan management and optimize insurance revenue

Responsibilities

· Develop modeling process to track negotiated rates and payor compliance with such rates).

· Recommend contract provisions and protections to minimize payer policy impacts on revenue to Manager of Payer Contract Analytics.

· Extract and manage data from systems such as Tableau and other databases using SQL.

· Develop alternative financial proposals within budget parameters.

· Prepare and present revised contract models and recommendations to leadership. Develop and quantify financial impacts of proposals for future years.

· Perform insurance contract analysis of target practices under consideration for purchase.

· Develop modeling process to benchmark reimbursement rates to contracted commercial, Medicare Advantage and Medicaid reimbursement levels. Collaborate with Revenue Cycle team to create a dynamic negotiated reimbursement dashboard.

· Build contract terms soon-to-be-purchased contract database to reflect negotiated rate changes.

· Develop ad hoc analysis or customized reports in support of initiatives as assigned; ensuring end results fulfill initial requests or project goals.

· Support all analytics as assigned.

Core Competencies:

Analytical Skills: Strong analytical and problem-solving abilities to interpret insurance data, identify trends, and make informed decisions to optimize insurance plan performance. Microsoft Office (Excel, PowerPoint, Visio), Tableau, and SQL proficiency required.

C-Suite Communication Experience: Proven track record in leading and nurturing high-performing teams to achieve operational excellence and strategic goals. Essential to possess clear, effective, and concise communication skills across all management levels.

Expectations

Performance Metrics: Drive key performance indicators related to insurance plan management. Work autonomously to create management level reports to enable data-driven decision-making.

Collaboration: Work closely with cross-functional teams, including revenue cycle, operations, and clinical leadership, to align insurance plan management strategies with overall organizational goals.

Continuous Improvement: Identify opportunities for process improvements, technology implementation, and innovation to enhance insurance plan management practices within the DSO.

Qualifications

· Bachelor’s degree or relevant military or professional healthcare experience required.

· 10 years of experience in Business Analysis, regardless of employment sector.

· Ability to travel up to 15%

· Ability to work remotely.