Remote Senior Dental Policy & Quality Leader

GEHA; Kansas; Hybrid; USD 94,000 - 119,000; Full time

Benefits offered by this job

Health/Vision/Dental benefits

401(k) retirement plan

Paid Time Off

Tuition Assistance Program

Job summary

GEHA seeks a Dental Policy & Quality Manager to own clinical policy, CDT coding standards, and data quality for our dental benefit programs. This senior contributor will translate dental expertise into policy infrastructure, including policy documents, member education, and vendor alignment.

The role conducts policy audits, updates coverage criteria to CDT standards, oversees the clinical review vendor and interfaces with OPM audits.

Qualifications

• Deep knowledge of dental benefits, CDT codes, and policy development.
• Experience translating complex dental policy into educator-friendly content.
• Ability to align policy with CDT updates and vendor practices.
• Proven track record with regulatory filings and audits.

Responsibilities

• Own development and maintenance of dental coverage policies and coding guidance.
• Audit and realign policies with CDT standards, vendor practices, and plan provisions.
• Serve as final dental policy authority for TPAs and external audits.
• Coordinate CDT reporting with TPA and Data & Analytics teams.
• Chair policy review with actuarial, compliance, legal, and operations stakeholders.
• Ensure documentation defensibility for federal audits.

Skills

Dental policy

CDT coding standards

Policy governance

Regulatory compliance

Education material development

Education

Bachelor's degree in Dental Hygiene, Health Administration, Health Informatics, or a related field

Tools

CDT coding standards

Job description

GEHA seeks a Dental Policy & Quality Manager to own clinical policy, CDT coding standards, and data quality for our dental benefit programs. This senior contributor will translate dental expertise into policy infrastructure, including policy documents, member education, and vendor alignment.

The role conducts policy audits, updates coverage criteria to CDT standards, oversees the clinical review vendor and interfaces with OPM audits.