Cathie Beatrici

Experience

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  Delta Dental of Missouri

  Feb 2010 - Dec 2024

  Provide daily leadership to the Professional Relations team and Utilization Management team in order to meet Delta Dental of Missouri goals and objectives. Facilitate and/or participate in targeted projects through team participation with DDMO to achieve our department goals and objectives. Professional Relations:Provide liaison support between Professional Relations team and all Delta Dental of Missouri departments. Responsible for monitoring network growth and retention to ensure growth and persistency goals.Ensure that all DDPA, regulatory and group performance guarantees related to network size and adequacy are met.Ensure that all network reporting to DDMO, OIG, groups and internal stakeholders is accurate and submitted within required timelines.Responsible for ensuring that provider education opportunities such as conventions and workshops are coordinated, executed and managed within budget.Develop and implement strategies to build new and existing networks in coordination with product development and purchaser needs.Responsible for ensuring provider communications are reviewed and approved for publishing.Acts as liaison between the dental community and Delta Dental of Missouri.Utilization Management:Responsible for the following relative to Claims Administration:Determines procedures for efficient and effective benefit review processes assuring the compliance of providers and subscribers with the provisions of employer dental contracts. Works with staff to adjudicate special claims and benefit review requests in a timely manner. Administer other dental related issues impacted by Delta Dental’s policies or procedures. Coordinate timely and accurate review of claims by dental consultants to achieve cycle-time and accuracy standards.Monitor and evaluate processes for claim grievances and appeals. Show less Responsible for development, maintenance and relationship building of Delta Dental of Missouri’s dental provider networks in their assigned regions. Responsible for timely resolution of provider inquiries and timely communication and education of provider networks on Delta Dental’s products, policies and procedures. Represent Delta Dental at provider community events. Assist in fraud and abuse investigations, including proper documentation and reporting. Responsible for recruiting dental providers in their respective markets as defined by company needs. Identify and recruit providers in new and existing areas in our various dental programs as directed. Recruitment includes contact with providers via phone, written correspondence and in-person meetings (requires intrastate travel).Contact providers through cold-calling, networking, following leads via phone and in person for the purpose of relationship building and recruitment.Communicate and foster relationships with dentists, dental office staff, dental societies, dental associations, Missouri Dental Board, member companies and others in the dental field.Communicate with provider offices to provide education, announcements or requested assistance.Maintain network participation by providing support to providers and office managers to improve their understanding of all available benefit programs.Respond to grievances and complaints and work toward timely resolutions as requested. Educate and inform the dental office personnel on all Delta Dental programs. Show less

  • Manager, Professional Relations & Utilization Management

    Jan 2017 - Dec 2024

  • Professional Relations Representative

    Jun 2013 - Dec 2016

  • Group Accounts

    Feb 2010 - Jun 2013
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  32Health

  Jan 2025 - now

  Director of Credentialing and Provider Networks