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Vice President, Chief Dental Officer/Dental Product Head

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Date Posted: Jul 5, 2022

Location(s): Bridgewater, NJ, US, 8807 New York, NY, US, 10166

Company: MetLife

About the Role:  Chief Dental Officer/Dental Product Head 

DEPARTMENT:  Group Benefits 
LOCATION:  NY/NJ USA

Reporting directly to the SVP of Supplemental Health Products, Group Benefits, this role(s) will have accountability for Dental product (PPO and DHMO) competitiveness leading to profitable growth; including product development, network development, claims standards, and clinical quality management.  Success requires both detailed Dental benefits expertise and understanding of market dynamics across both geographic and employer market segments – i.e. National, Regional, and Small markets.  Ideally, this individual will be a licensed dentist who has experience maintaining clinical standards to manage utilization across both insured and self-funded contracts, in line with current standards of care.  

Key responsibilities include:
•    Product Development
•    Network Development
•    Clinical Management
•    Sales Support and Industry Representation

 

Key Relationships: 
Current Direct Reports: 
•    AVP Networks 
•    Director Product Development 
•    DHMO  Dental Directors – TX and CA
•    Director of Quality Initiatives 

Other Key Stakeholders:  Market Leaders, Heads of Sales, National and Regional Sales Leaders and Marketing, Pricing and Claims

 

Responsibilities:
1.    Direct Claim Management Initiatives
Responsible for the development, initiation and monitoring of all Claim Management initiatives that insure claims are being properly benefited in accordance with MetLife’s contracts/certificates/ASA agreements.  


2.    Set Clinical Policies for the Dental Product 
Provide the specifics around clinical policies as they relate to both the insured and ASO blocks of business.  This includes the systematic review of the current dental research and literature that is pertinent in relation to utilization management programs and claims processing, plan design, product development, and compliance.


3.    Support Dental Product Compliance
Own the process involving the Current Dental Terminology updates/revisions mandated by HIPAA including coordinating the clinical decisions and initiating the necessary programming changes to the Claims system to insure compliance.  Serve as a representative for MetLife on both the NADP and AHIP current dental terminology committees.  Act as a resource to the DPM compliance personnel for all matters related to both insured and ASO blocks of business.


4.    Develop Market Leadership
Deliver continuing education courses to the broker/consultant/agent community.  Participate in the formation of oral health education materials that are disseminated to individuals covered by MetLife dental plans.  Develop disease management plan design concepts.

 

5.    Chair the Quality Management Committee for the Dental Product
Responsible for the Quality Management Committee for DPM that addresses issues of PDP grievances, balance billing, network credentialing, office audit low scoring dental offices and compliance complaints and the MetLife Dental Advisory Council.


6.    Lead Dental Product Development Team
Leads direction and oversees new products and innovation in all aspects of the dental product.  Serve as a subject matter expert for the development of new dental product offerings from a plan design concept including network, marketplace, and financial considerations.  Develop new dental products and features designed to differentiate MetLife in the dental benefits markets.  Product development activities are conducted in collaboration with market strategy owners.


7.    Lead Network Development Team 
Leads direction and oversees management and expansion of dental networks.  Set the regional direction and management of the PPO and DHMO networks for growth and retention strategies.  Work closely with the dental pricing finance team to develop network financial strategies and fee schedule development.

 

8.    Provide Subject Matter Expertise and Support for all Market Segments
Act as a support resource for all market segments including MetLife field representatives, National Account client service personnel, and the National Service Center.  These responsibilities include providing dental consultative services in regards to plan design for clients, participation in finalist sales presentations, providing a clinical resource in relation to client/field questions and claim resolution, and positioning MetLife’s value proposition in the marketplace.  These responsibilities directly affect top line revenue through driving new sales growth and persistency of current clients.


9.    Thought Leadership:  Responsible for the Development and Implementation of Wellness and Disease Management Programs.
This includes the design and initiation of the programming that is necessary for a disease management program.  This initiative involves the coordination between MetLife, an outside vendor and current dental clients.  This program is a market differentiator from MetLife’s competitors.


CANDIDATE QUALIFICATIONS:
Business Knowledge/Technical Skills: 
•    10-15 years of senior level experience in the group insurance marketplace.  
•    Advanced knowledge of insurance industry, group and voluntary benefit products, with focus on Dental benefits
•    Strong understanding of business drivers and financial performance measures
•    Knowledge / experience with supported products, market, industry, and business 
•    Licensed Dentist
•    Strong ability to manage senior level professionals.
•    Strong communication and presentation skills.
•    Ability to drive results through direct lines of accountability and through partnership relationships.
•    Strong change leadership skills.
•    Strong professional business acumen.
•    Strong ability to hold people accountable and drive business results.