Responsibilities
- Process, prepare, and deliver contractual and regulatory deliverables to the organization’s CCO partners – ensuring timeliness standards
- Audit products produced by all areas of Plan Operations to ensure compliance with contractual and regulatory compliance and report findings to management
- Assist with base level data pulls for provider auditing/monitoring purposes.
- Assis with the development and review of department SOPs.
- Have full knowledge of all Plan policies in order to communicate these accurately to contracted providers.
- Meet documented quantity and quality standards.
- Other duties as needed or required
Requirements
- High school diploma or equivalent
- Working knowledge of dental procedures and experience in reading and comprehension of dental records
- 2+ years working of working knowledge of OHA and CCO regulatory compliance
- 2+ years of experience working in a Medicaid dental environment
- Computer proficiency in a variety of Windows applications
- Attends additional training as requested/deemed necessary
Benefits
- generous vacation and sick time
- market-leading paid family, parental and adoption leave
- medical coverage
- company paid life and AD&D insurance
- disability programs
- a partially paid sabbatical program
- 401(k) employer match
- stock purchase options
- an employer-funded retirement account
Additional Information
- Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you!
- We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.
- We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate.
- We encourage applications from qualified individuals from all backgrounds.
- We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business.
- Please email thebrightside@sunlife.com to request an accommodation.
- For applicants residing in California, please read our employee California
- We do not require or administer lie detector tests as a condition of employment or continued employment.
- Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.
- All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
