Serves as liaison to other Delta Dental Plans, representing the Tri-State operation for new and existing DeltaUSA business activities; and monitors and audits provider network access and adequacy issues for Medicaid and Medicare business.

• Works closely with Sales, Legal and Compliance and Government Funded Programs division on the administration of Medicaid and Medicare business as it pertains to provider network requirements and network adequacy standards.

• Conducts monthly and quarterly network adequacy audits for Medicaid and Medicare groups as required by CMS.

• Develops departmental policies and procedures required for Medicaid and Medicare business.

• Assists with special projects as appointed by the department director.

• Assists in the development of recruitment strategies, researches, analyzes and generates various provider and group reports for DeltaUSA business to support provider network expansion or resolve disruption in the Tri-State territory, and orchestrates recruitment efforts based on the needs of internal and external customers.

• Develops and generates earnings and county group report queries for recruitment and retention of dentists, and trains staff on the use of reports generated.

• Develops a variety of documents, surveys, communications and mailings for DeltaUSA and Medicaid and Medicare business activity.

• Assists with NPF audits as needed and all tasks associated with the annual initiative.

• Administers Salesforce user support to Professional Services Representatives. Works with Salesforce Administrator and IT staff to resolve Provider data issues in Salesforce. Develops, generates and monitors a variety of reports from logged activities completed by the field representative.