Senior Program Manager, Provider Reimbursement bei Delta Dental of Washington

Are you passionate about building programs that support the provider experience through effective reimbursement strategies? We’re looking for a Senior Program Manager to lead and support our provider reimbursement initiatives and help us deliver meaningful value to all stakeholders including providers, employers and members. In this role, you will be responsible for designing, implementing, and optimizing value-based reimbursement programs that improve provider satisfaction, align with regulatory standards, and support the company’s strategic goals. You’ll manage staff members and lead cross-functional efforts to design the next evolution of dental reimbursement strategies, ensure operational efficiency, and strengthen relationships with our provider partners.

At Delta Dental of Washington our vision is that all people can enjoy good oral and overall health, with no one left behind. We succeed because of a shared commitment to a set of values that guide everything we do – for our customers, for our communities, and for each other. We are Accountable. We lean in with Courage. We stay Curious. We are Inclusive. We act with Integrity.

We offer a highly competitive medical, dental and vision plans as well offering a generous 401k match and all employees start accruing vacation and sick time from their very first day. We empower employee development through our tuition reimbursement plan, professional development plans, and employee-led communities.

The pay range for this position in Western Washington varies between $109,000 – $155,400, and for Eastern Washington varies between $92,800 - $132,000. Washington Dental Service and its affiliates, including Arcora Foundation, Delta Dental of Washington, and TriForza Corp. intends to offer the selected candidate a base pay within this range, dependent on job-related, non-discriminatory factors such as experience. Base pay will also be adjusted based on the candidate's geographic location.

Essential Responsibilities include the following: The responsibilities listed are not intended to be comprehensive. Washington Dental Service and its affiliates, including Arcora Foundation, Delta Dental of Washington, and TriForza reserve the right to change the responsibilities at any time with or without notice.

• Lead the end-to-end design, delivery, and continuous improvement of provider reimbursement programs, including roadmap creation, milestone tracking, and business case development.
• Support the definition and execution of reimbursement strategies aligned with business goals and provider partnership objectives.
•  Manage and develop the Provider Reimbursement team by defining roles, organizing work, and providing guidance on training, performance management, and professional development strategies.
• Leverage claims data, provider behavior, and reimbursement trends to develop strategic insights through forecasting, ROI analysis, and cost modeling that inform reimbursement model design and drive program performance.
•  Define and monitor key performance indicators (KPIs) to evaluate the performance of value-based reimbursement programs and identify opportunities for continuous improvement.
• Lead cross-functional initiatives to implement, scale, and advocate for provider reimbursement programs in collaboration with clinical, legal, compliance, underwriting, and operational teams.
• Regularly engage and present to key Board Committees on network compensation strategy, updates and outcomes.
•  Ensure compliance with federal, state, and internal regulatory standards across all reimbursement initiatives
•  Build and maintain strong relationships with provider partners and internal stakeholders to drive alignment, foster trust, and ensure successful adoption of reimbursement programs.
• Provide subject matter expertise and strategic guidance on provider reimbursement initiatives, ensuring effective program design, proactive change management, and stakeholder alignment.
• Identify opportunities to scale and evolve reimbursement capabilities in alignment with emerging industry trends, regulatory changes, and organizational priorities.

The experience, skills, and education needed to succeed in the position are outlined below. These requirements are representative of the knowledge, skills, and abilities required to successfully perform the essential functions of the role.

• 5–8 years of experience leading the end-to-end delivery of programs, including roadmap development, milestone tracking, and cross-functional coordination
• Strong knowledge of healthcare insurance, provider reimbursement methodologies, coding standards, and claims adjudication
• Ability to guide, support, and develop team members through mentorship, training, and performance feedback to foster growth and improvement.
• Proven experience leading cross-functional program initiatives in a matrixed environment
• Demonstrated ability to analyze data and translate insights into strategic program decisions
• Familiarity with provider network operations and the impact of reimbursement programs on provider engagement and satisfaction
• Proven ability to develop business cases, define key performance indicators (KPIs), and conduct forecasting and ROI analyses to inform the design, implementation, and evaluation of provider reimbursement models.
• Ability to align program objectives with broader organizational strategy and provider partnership goals
• Proficiency in applying project management tools (e.g., Smartsheet, Asana, Jira) to monitor tasks, assign responsibilities, and manage timelines
• Familiarity with healthcare regulatory compliance at both state and federal levels
• Excellent verbal and written communication skills with an ability to influence and build relationships with both internal and external stakeholders

Washington Dental Service and its affiliates, including Arcora Foundation, Delta Dental of Washington, and TriForza are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

We are committed to the highest standards of information security and HIPAA compliance, ensuring the confidentiality, integrity, and protection of all data. All staff are expected to support this commitment by following relevant policies.