The Manager of Policy Management & Provider Strategy is a strategic leader responsible for advancing quality outcomes and accurate payment through the development and execution of integrated policy and provider strategies. This role leads the governance, coordination, and communication of clinical and operational policies, ensuring alignment with enterprise goals, regulatory standards, and quality initiatives. As a key partner across the enterprise and with external stakeholders, this role plays a critical part in shaping and executing the Quality roadmap—driving strategic alignment between policy management, provider oversight, and payment quality. The manager also champions enterprise-wide education and awareness efforts to build understanding of policy intent, application, and impact.
- Leads initiatives and programs—both directly and through influence—focused on policy development, governance, quality-focused provider strategy, and education around payment quality management. Partners across all lines of business and collaborates with key departments including Sales, Claims, Dental Affairs, Actuarial, Provider Network Development, Utilization Management, and Grievance and Appeals to ensure alignment and execution.
- Leads a team and supports the collaborative drafting, publishing, communication, transparency and management of clinical and business policies.
- Directs the design and delivery of communication strategies, ensuring all communications build understanding of policy intent and quality expectations among internal teams and external partners.
- Oversees the strategic coordination and operational management of the Business Policy Decisioning Council, including intake, triage, meeting cadence, and communications. Partners with requestors to ensure proposals are well-prepared and aligned with business objectives prior to review.
- Leads the development and ongoing management of centralized policy resources that guide the administration of clinical and non-clinical policies, contractual obligations, and regulatory requirements. Ensures these resources drive quality outcomes, support accurate payment practices, and influence provider behavior in alignment with enterprise goals.
- Leads cross-functional collaboration to shape and evolve the quality provider strategy, driving prioritization and roadmap execution to strengthen provider partnerships and ensure accountability to the highest standards of quality care.
- Participates in annual strategy and planning sessions and contributes to the development of support materials to ensure there is a clear Quality roadmap and plan to monitor and improve quality outcomes, payment, and provider behavior.
- Oversees the cross-functional design, implementation, and ongoing administration of enterprise provider incentive programs.
- Manages and develops multi-disciplinary teams to achieve strategic objectives, encompassing determining staffing needs, setting goals, monitoring performance, interviewing, selecting, coaching, and evaluating the performance of all direct reports, and overseeing, and maintaining department budgets.
- 8+ years w/Bachelor’s degree; 1+ years supervisory/management.
- Strong people leadership skillsets, including talent development and the ability to realize strategies through a team.
- High detail orientation with strong analytical, critical thinking and problem-solving skills.
- Excellent organizational/time management and project management skills.
- Extensive knowledge of health care industry.
- Excellent interpersonal, verbal, and written communication skills, including proven ability to collaborate and influence across all functions and levels of the organization.
- Proven ability to resolve conflict and facilitate decision-making.
- Ability to quickly extract key insights from complex data and details.
- Ability to translate an opportunity into an educational campaign, leveraging multiple mediums.
Base Pay Information
The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental’s assessment of the candidate’s knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity.
Pay Grade 22. $92,500 - $200,400
Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones. This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes:
- Competitive base and incentive pay
- 401(k) with robust matching and non-matching contributions
- Rich medical & pharmacy benefits
- 100% employer-paid dental and vision benefits
- Holistic wellbeing program with deep financial incentives
- Generous paid time off plus 12 paid holidays and your birthday off
- Culture of growth and learning: career development; tuition reimbursement; recognition program
- Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
- Social responsibility and volunteer opportunities
- Employee discount program
Fair Chance Ordinances and Criminal Background Considerations This position requires that the applicant undergo a background check. Qualified applicants with arrest or conviction records will be considered for employment in accordance with any applicable federal, state or local laws, including, but not limited to, the California Fair Chance Act, the Los Angeles County Fair Chance Ordinance, the City of Los Angeles Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, and/or New York Corrections Law Article 23-A.
Originally posted on Himalayas
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