PCDH Coordinator and Tribal Liaison

Delta Dental of Michigan; Okemos (MI); Hybrid; USD 55,000 - 70,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana is seeking a PCDH Coordinator and Tribal Liaison in Okemos, MI. The role administers the Patient Centered Dental Home assignment process and related program activities, partnering with internal and external organizations to support member education and engagement.

As primary liaison to Tribal Nations and Tribal health programs, you will collaborate with providers, MCOs, case managers, and communities to promote preventive services, improve access to

Qualifications

• Bachelor's degree in healthcare administration, business administration, public health, dental hygiene, community health, social work, or a related field.
• Three years of experience in patient care coordination, healthcare program administration, community outreach, population health, or public health; Tribal background or experience with Tribal Nations is preferred.

Responsibilities

• Supports key areas of DDMI and the Contractor's Dental Home Strategy priorities by monitoring utilization, prioritizing increased use of high-value preventive dental services, and supporting the design of responsibilities and high-value activities.
• Implements Dental Home Strategy outreach, coaching, education, and engagement activities for members and providers.
• Collaborates with the project management team to update, revise, and enhance the Dental Home workflows in Roosevelt.
• Reviews and analyzes Patient Centered Dental Home reports, utilization trends, provider manual content, and member handbook references to identify opportunities and barriers related to dental care utilization.
• Promotes access to preventive services through a trusted primary care dentist to support oral disease prevention, continuity of care, and reduced avoidable restorative care needs.
• Facilitates communication among members, dental providers, Managed Care Organizations(MCO), case managers, community partners, and healthcare professionals to support member engagement and continuity of care.
• Develops, recommends, implements, and supports Dental Home Strategy policies, procedures, guidelines, operating standards, and compliance activities in alignment with applicable healthcare regulations, contractual requirements, and organizational standards.
• Tracks provider terminations and coordinates member reassignment to another Dental Home as needed, including reassignments requested by DDMI, providers, MCOs, or members.
• Serves as the primary point of contact for Tribal partners regarding Dental Home assignment processes, member outreach, oral health initiatives, access-to-care concerns, and community partnership opportunities.
• Participates in Tribal meetings, community outreach events, health fairs, and stakeholder forums to promote oral health education, Dental Home engagement, and community partnerships.
• Assists in developing and implementing culturally and linguistically appropriate communication materials, outreach campaigns, and member education resources for Tribal and Indigenous communities.
• Monitors applicable Tribal, state, and federal requirements related to Tribal engagement and healthcare programs and supports compliance with contractual and regulatory requirements.
• Supports quality improvement initiatives, population health programs, and Dental Home performance measures affecting Tribal and Indigenous populations, using engagement activity and access-trend data to inform continuous improvement.
• Prepares reports, presentations, and recommendations for leadership regarding Tribal engagement, Dental Home utilization trends, outreach outcomes, member access trends, and opportunities to improve member access, experience, and health outcomes.

Job description

Job Summary

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

Job Details

PCDH Coordinator and Tribal Liaison

Number of Positions: 1

Location: Okemos, MI

Location Specifics: Hybrid Position

Position Description

Administers the Patient Centered Dental Home (PCDH) assignment process and related program activities, including system and workflow updates, provider and member requests, reporting, and stakeholder communication. Supports member education and engagement in dental care through collaboration with internal and external partners and serves as the primary organizational liaison to Tribal Nations and Tribal health programs.

Primary Job Responsibilities

• Supports key areas of DDMI and the Contractor's Dental Home Strategy priorities by monitoring utilization, prioritizing increased use of high-value preventive dental services, and supporting the design of responsibilities and high-value activities.
• Implements Dental Home Strategy outreach, coaching, education, and engagement activities for members and providers.
• Collaborates with the project management team to update, revise, and enhance the Dental Home workflows in Roosevelt.
• Reviews and analyzes Patient Centered Dental Home reports, utilization trends, provider manual content, and member handbook references to identify opportunities and barriers related to dental care utilization.
• Promotes access to preventive services through a trusted primary care dentist to support oral disease prevention, continuity of care, and reduced avoidable restorative care needs.
• Facilitates communication among members, dental providers, Managed Care Organizations(MCO), case managers, community partners, and healthcare professionals to support member engagement and continuity of care.
• Develops, recommends, implements, and supports Dental Home Strategy policies, procedures, guidelines, operating standards, and compliance activities in alignment with applicable healthcare regulations, contractual requirements, and organizational standards.
• Tracks provider terminations and coordinates member reassignment to another Dental Home as needed, including reassignments requested by DDMI, providers, MCOs, or members.
• Serves as the primary point of contact for Tribal partners regarding Dental Home assignment processes, member outreach, oral health initiatives, access-to-care concerns, and community partnership opportunities.
• Participates in Tribal meetings, community outreach events, health fairs, and stakeholder forums to promote oral health education, Dental Home engagement, and community partnerships.
• Assists in developing and implementing culturally and linguistically appropriate communication materials, outreach campaigns, and member education resources for Tribal and Indigenous communities.
• Monitors applicable Tribal, state, and federal requirements related to Tribal engagement and healthcare programs and supports compliance with contractual and regulatory requirements.
• Supports quality improvement initiatives, population health programs, and Dental Home performance measures affecting Tribal and Indigenous populations, using engagement activity and access-trend data to inform continuous improvement.
• Prepares reports, presentations, and recommendations for leadership regarding Tribal engagement, Dental Home utilization trends, outreach outcomes, member access trends, and opportunities to improve member access, experience, and health outcomes.

Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

Minimum Requirements

Position requires a bachelor's degree in healthcare administration, business administration, public health, dental hygiene, community health, social work, or a related field, three years of experience in patient care coordination, healthcare program administration, community outreach, population health, or public health, and a Tribal background or experience working with Tribal Nations, Tribal health programs, Urban Indian Organizations, or Indigenous communities that provides sufficient familiarity with the Indian health care delivery system and managed care protections. Experience working with Medicaid populations and community-based health initiatives is preferred. Will accept any suitable combination of education, training, or experience.

Position requires knowledge of Patient Centered Dental Home principles, care coordination, oral health promotion, and population health management; ability to establish and maintain productive relationships with Tribal leaders, community organizations, healthcare providers, and government stakeholders; strong cultural competency skills with the ability to develop and support culturally responsive programs and communications; excellent communication, presentation, project management, and stakeholder engagement skills; and the ability to analyze data, identify utilization trends, and develop actionable recommendations to improve member engagement and access to care.

Required travel up to 25% to provider offices, Tribal communities, healthcare facilities, community events, and stakeholder meetings throughout the service area.

Equal Employment Opportunity

The company will provide 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.