Manager, Government Programs Third Party Liability and Coordination of Benefits

Position Description Provides strategic leadership and operational oversight of Government Programs Third Party Liability (TPL) and Coordination of Benefits (COB) operations to ensure accurate identification, coordination, recovery and reporting of third‑party coverage in compliance with federal and state Medicare and Medicaid regulations. Leads the end‑to‑end TPL/COB strategy, cost avoidance, post‑payment recovery, and vendor management to meet contractual, regulatory, and financial objectives. Designs, documents, and implements TPL/COB policies, procedures and workflows aligned with CMS Medicare and state Medicaid requirements, translating regulatory requirements into operational practice. Develops, monitors, and reports key performance metrics related to recoveries, cost avoidance savings, and accuracy; drives accountability through regular performance reviews and action planning. Identifies and executes opportunities to improve TPL/COB recovery yield, increase automation, strengthen controls, and enhance overall operational efficiency across TPL/COB processes. Serves as the Government Programs TPL/COB subject‑matter expert, providing guidance on benefit coordination, payment order, recovery methodologies and operational interpretation of regulatory requirements. Champions TPL/COB processing enhancements and cross‑functional initiatives that advance Government Programs goals, including system improvements, workflow redesign, and change management adoption. Partners with business and technology stakeholders to define and deliver the TPL/COB strategic roadmap, including requirements definition, prioritization, implementation planning, and clear communication of impacts to affected teams. Leads and coordinates support for CMS, state and other regulatory audits and reviews related to TPL/COB, including data requests, documentation, issue remediation, and ongoing compliance monitoring. Interviews, hires, trains, develops, and evaluates staff to ensure accountability for the achievement of corporate and department goals and objectives. Minimum Requirements Bachelor’s degree in healthcare administration, business administration, finance or a related field. Seven years of government programs third‑party liability/coordination of benefits experience. Three years of leadership experience and the ability to lead and motivate others. Advanced knowledge, experience and understanding of state and federal regulations related to TPL/COB for government programs including Medicare and Medicaid. Strong verbal and written communication skills, including the ability to present on behalf of the organization. Strong interpersonal, analytical, advocacy and problem‑solving skills. Ability to identify and partner with key business leaders and to work under pressure while managing multiple complex priorities. Benefits Employees are offered a comprehensive benefits package that includes medical, dental and vision coverage, short‑ and long‑term disability, life insurance, 401(k) savings plans, flexible spending accounts, and tuition reimbursement or educational assistance. Employees are also eligible for annual incentive compensation based on annual business goals and receive eight hours of paid volunteer time each year, access to an on‑staff health coach and personal trainer, plus many other perks. Equal Employment Opportunity Delta Dental of Michigan, Ohio, and Indiana provides equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status or any other status protected under federal, state, or local law or ordinance. Delta Dental is an Equal Opportunity Employer. #J-18808-Ljbffr