Director, Provider Engagement

Sun Life

full-time

Posted on: 10/17/2025

Location Type: Hybrid

Location: Kansas City • Kansas • 🇺🇸 United States

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Salary

💰 $129,800 - $194,700 per year

Job Level

Lead

About the role

Oversee the development and execution of, as well as provide support and direction to, the Provider Engagement team in support of all products
Own applicable P&Ps, SOPs, SLAs and ensure compliance with them
Develop innovative, competitive, cost effective and quality networks for all products in support of new sales and existing client retention
Champion provider adoption/utilization of digital platforms/tools
Provide support and direction to the team to ensure appropriate allocation of resources to meet multiple deliverables and participate in a wide range of network focused initiatives
Establish provider network targets, recruit/contract new providers and work with existing providers to move them along the cost and quality continuum.
Develop strategies to increase member access, preventive care, increase quality and outcomes, while decreasing costs
Collaborate with other areas to ensure members assignments and dental home programs meet cost, quality, access and capacity goals
Review and submit for approval special deal requests, retroactive adjustments, reimbursement, and contract exceptions
Use available tools and resources to conduct Network Adequacy, Compliance, Validation, Accuracy, Appointment Availability, and other related activities as required/needed
Collaborate with other enterprise functions to drive improvements in Provider Data Integrity
Support and assist credentialing to obtain missing credentialing information
Collaborate with Marketing, Communications, Governmental Relations, Clinical and Client teams to position the organization favorably and achieve desired business results
Partner in responding to Request for Proposals (RFPs) to illustrate network strategies as a competitive advantage to grow new business and retain existing business
Strategize with analytics and other teams on best approaches for collection, evaluation, compilation, and dissemination of data consistent with requirements and goals
Assess environmental trends, needs, and opportunities to inform decision makers internally and externally on opportunities to execute provider programs that achieve annual business goals.
Monitor portfolio of contract operations ensuring successful execution of operating plan objectives and achievement of outcome/success measures for Providers
Develop and manage department budgets and resources consistent with short and long term financial and operational goals
Proactively research competitors’ provider panels; fee schedule and reimbursement methodologies; policies and procedures; tools and technology; processes, etc.; and make recommendations to meet or exceed competition
Build and maintain relationships with leaders of local dental associations, FQHCs, Public Health, dental schools, large group practices and other key provider stakeholders
Collaborate with Client team to meet network needs and participate in on-site meetings, virtual meetings, conference calls, and day-to-day interaction with clients, prospective clients, organized dentistry, and other key industry stakeholders
Direct team on the appropriate preparation of client audits, CAPs, and ad hoc report documents
Oversee other engagement activities and projects related to the provider network
Ensure internal and external network reports are prepared and delivered accurately and timely
Develop solutions to improve participating provider satisfaction and innovative approaches to advance recruitment strategies to attract providers to join all lines of business
Develop and maintain provider reimbursement models in line with cost of care goals, market research and profitability/loss ratio objectives, using effective negotiating strategies
Draft Provider Agreements, Restated Agreements, Amendments, and other communications as needed and by working with legal and marketing
Organize, assess and problem solve workflows with other departments to ensure efficient, timely and accurate outcomes
Coordinate and implement appropriate performance management strategies for team members to include: Assist in the hiring process, including interviewing candidates
Assist, train and motivate team members to Evaluate and measure effectiveness of team members
Assist in preparation of performance and wage evaluations in accordance to company policy
Responsible for attendance and company approved time off for team members
Participate in the determination and implementation of Performance Improvement Plans and performance management initiatives.
Design reports to effectively manage team members
Train and coach team to be knowledgeable in all aspects of their role and responsibilities
Other duties as assigned.

Requirements

Bachelor's degree in business, healthcare administration, or related/applicable degrees, e.g., marketing, communications, finance, etc.
Ten (10) years of related experience in management with experience in business or healthcare administration, finance or another related field preferred
Ten (10) years of demonstrated leadership in the development, monitoring, and successful implementation of organizational strategy
Ten (10) years of experience in client and provider relationship management
Five (5) years of experience in process or operational management
The ability to think analytically, decipher and understand complex data
The ability to design and manage complex organizational policies and communications and obtain corporate and divisional cross functional support
Ability to manage multiple projects simultaneously
Comprehensive knowledge of the healthcare industry and payment methodologies, including Value Based or Alternative Payment Models
Demonstrated skill in recruiting, training, coaching, managing, motivating and developing staff
Demonstrated skill in financial and budget management
Executive-level written and verbal communication, presentation, interaction and persuasive skills
Demonstrated skill in high-level decision-making and problem-solving
Proficiency with general computer software (Excel, Word, and PowerPoint)
Ability to work in a fast-paced, results-driven environment.

Benefits

health insurance
retirement plans
paid time off
flexible work arrangements
professional development
bonuses
stock options

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills

provider engagementnetwork developmentbudget managementdata analysisrecruitment strategiesprovider reimbursement modelsperformance managementcontract managementcompliance managementprocess management

Soft skills

leadershipanalytical thinkingcommunicationproblem-solvingproject managementteam motivationstrategic thinkingrelationship managementdecision-makingtraining and coaching

Director, Provider Engagement

Salary

Job Level

About the role

Requirements

Applicant Tracking System Keywords

Hard skills

Soft skills

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