Manager, Dental Network Oversight

Government Employees Health Association, Inc. (G.E.H.A) is a nonprofit member association that provides health and dental benefits that millions of federal employees and retirees, military retirees and their families have counted on since 1937. Offering one of the largest health and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care.

G.E.H.A has one mission: To empower federal workers to be healthy and well.

SKILLS

Duties and Responsibilities:

• Lead the dental network oversight function for G.E.H.A, establishing governance routines, performance expectations, savings monitoring, access reviews, partner accountability, reporting standards, and executive-ready action tracking across CDN, TPA, and internal stakeholders.
• Own dental network adequacy performance for G.E.H.A’s dental members, using access metrics by geography, specialty, and product line to direct network development priorities and close gaps for G.E.H.A Connection Dental Federal through the Federal Employees Dental and Vision Insurance Program (FEDVIP) and Connection Dental Plus (CD+).
• Evaluate G.E.H.A’s owned and contracted dental network model to determine whether current network strategy supports access, affordability, competitiveness, specialty coverage, provider availability, savings performance, and regulatory expectations.
• Identify and quantify network savings opportunities by analyzing utilization patterns, reimbursement trends, fee schedule performance, provider participation, market dynamics, and member value.
• Serve as the primary strategic point of accountability between Dental Product and the CDN team, aligning dental network priorities, resolving competing objectives, and ensuring network decisions support program performance and enterprise goals.
• Hold internal and external partners accountable for agreed-upon outcomes, ensuring performance concerns are escalated appropriately, corrective actions are implemented, and improvements are sustained through clear governance and follow-up.
• Support network expansion and market evaluation activities by defining business needs, assessing partner or market options, contributing to evaluation criteria, and coordinating limited RFP-related input when additional network solutions are required.
• Advance network innovation opportunities, including quality-focused approaches, provider performance models, improved access strategies, data-driven oversight tools, and capabilities that support affordability, transparency, and provider experience.
• Oversee provider complaint and escalation governance by ensuring recurring themes are analyzed, ownership is assigned, root causes are addressed, and escalation insights inform strategic network decisions.
• Develop executive-level dashboards, scorecards, and leadership updates that communicate network performance, savings opportunities, access risks, escalation themes, open issues, recommended actions, and decision points.
• Anticipate network-related risks to G.E.H.A’s dental program performance and drive mitigation plans with defined owners, timelines, measurable outcomes, and appropriate leadership visibility.
• Shape the future network oversight operating model by defining core functions, documenting scalable processes, identifying staffing needs, developing training materials, and preparing the function for future people-leadership responsibilities as it expands.

Knowledge, Skills, and Abilities:

• Bachelor’s degree in business administration, Health Administration, or a related field.
• Requires a minimum of 8 years of progressively responsible experience in provider network management, dental network operations, provider relations, health plan operations, network strategy, or network performance oversight, including accountability for complex vendor or partner relationships.
• Minimum of 3 years of experience supporting or managing network oversight, network adequacy monitoring, savings analysis, provider performance improvement, escalation governance, or cross-functional operational initiatives required.
• Experience evaluating dental or health plan provider networks, network development strategies, access standards, provider availability, savings performance, provider communications, and root-cause improvement opportunities strongly preferred.
• Experience leading cross-functional or matrixed initiatives and holding third-party administrators, network partners, or operational teams accountable for defined outcomes required.
• Experience developing or using dashboards, scorecards, executive reporting, issue logs, action plans, savings analysis, or performance governance tools required.
• Experience with FEDVIP, OPM-regulated programs, federal employee benefits, or other highly regulated health plan environments strongly preferred.
• Experience preparing strategic recommendations, performance trends, risks, savings opportunities, and corrective actions for leadership review preferred.
• Experience supporting network expansion analysis, partner evaluation, procurement input, limited RFP support, or implementation planning for provider network solutions preferred.
• Strategic network management capability, with the ability to connect network performance, savings trends, access gaps, provider participation, and member value to broader business priorities.
• Advanced analytical judgment: able to interpret network adequacy, utilization, savings, escalation, and partner performance data to identify risk, develop recommendations, and drive enterprise-level decisions.
• Strong executive presence and influence, with the ability to lead through matrixed relationships, align competing priorities, and hold partners accountable without direct authority.
• Excellent executive communication skills, including the ability to translate complex network performance issues, savings opportunities, access risks, and recommendations into clear leadership-level narratives and decision points.
• Demonstrated ability to establish scalable governance structures, performance routines, issue management processes, and action plans across multiple strategic and operational workstreams.
• Strong provider-centered and member-value mindset, with the credibility to engage provider relations, network development, operations, analytics, and partner teams on network performance, affordability, and experience improvement.
• Ability to identify and responsibly apply AI-enabled tools, automation, or workflow improvements to support reporting, trend identification, provider issue tracking, communication review, and operational efficiency while maintaining appropriate governance, accuracy, and compliance oversight.
• Proficiency in Microsoft Office Suite required; experience with network reporting tools, Tableau/Power BI, provider directories, claims or provider servicing platforms, AI-enabled productivity tools, or GIS/network access mapping preferred.

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.

• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.

• Latency (ping) response time lower than 80 ms

• Hotspots, satellite and wireless internet service is NOT allowed for this role.

• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges

• Incentive plan

• Health/Vision/Dental benefits effective day one

• 401(k) retirement plan:  company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution   

• Robust employee well-being program

• Paid Time Off

• Personal Community Enrichment Time

• Company-provided Basic Life and AD&D

• Company-provided Short-Term & Long-Term Disability

• Tuition Assistance Program

While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.

Please note that the salary information is a general guideline only.  G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees.

G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.