Dental Director, Government Programs & Utilization

rhsc; Okemos (MI); Hybride; USD 150 000 - 230 000; Plein temps

Résumé du poste

Delta Dental of Michigan, Ohio, and Indiana seeks an Associate Dental Director for Government Programs Dental Consulting and Utilization Management. Hybrid position in Okemos, MI, leading clinical staff and overseeing utilization management for government programs.

The role provides advanced clinical guidance, coordinates workloads, audits, training, and complex determinations for prior authorizations, reconsiderations, appeals, and state hearings.

Qualifications

• Must have a D.D.S. or D.M.D. from an accredited school of dentistry.
• Current, unrestricted license to practice dentistry, including state licensure as required.
• Ten years of clinical dental practice experience preferred; Medicaid/Medicare or government program experience is advantageous.

Responsabilités

• Performs claims adjudication and processing in compliance with applicable statutes, regulations, code sets, and policy.
• Assigns and adjusts clinical worklists and priorities to meet turnaround times and balance workload.
• Monitors productivity, quality, turnaround times, calibration, and adherence to clinical criteria; identifies trends and actions.

Formation

D.D.S./D.M.D. degree

Description du poste

Delta Dental of Michigan, Ohio, and Indiana seeks an Associate Dental Director for Government Programs Dental Consulting and Utilization Management. Hybrid position in Okemos, MI, leading clinical staff and overseeing utilization management for government programs.

The role provides advanced clinical guidance, coordinates workloads, audits, training, and complex determinations for prior authorizations, reconsiderations, appeals, and state hearings.