Delta Dental of Michigan
Associate Dental Director
Delta Dental of Michigan, Nashville, Tennessee, United States, 37247
Associate Dental Director – Delta Dental of Michigan
Location: Nashville, TN. Salary: $185,000 - $325,000. Job Summary
Supports oversight of clinical integrity, quality, and efficiency of dental services under the Tennessee Medicaid dental insurance program and ensures all dental care delivered meets highest standards and complies with federal and state regulations. Primary Responsibilities
Supports the oversight of clinical operations to ensure delivery of high‑quality dental care in compliance with all applicable standards and in support of the Delta Dental Utilization Management Program Plan. Participates in the development and implementation of quality assurance initiatives. Monitors and evaluates clinical performance metrics to ensure continuous improvement in service delivery. Conducts regular audits and reviews of clinical services to ensure quality and compliance with contractual guidelines and requirements. Provides clinical guidance and support to network dental providers to enhance patient care quality. Develops and facilitates provider education and training programs to promote adherence to clinical guidelines and Medicaid policies. Supports the development and implementation of innovative programs to enhance access to care and improve health outcomes. Stays informed about changes in Medicaid policies and updates clinical practices accordingly to ensure compliance with all federal and state regulations and nationally recognized quality standards. Promotes patient‑centered care and support initiatives that enhance patient education and engagement. Collaborates with community organizations and stakeholders through regular meetings and attendance at community events to promote benefit awareness, oral health education and preventive care. Reviews and adjudicates prior authorizations and retrospective claims submitted by providers in accordance with company utilization management standards, clinical policies and Medicaid guidelines. Minimum Requirements
Position requires a D.D.S. or D.M.D. from an accredited school of dentistry, an unrestricted license to practice dentistry in Tennessee, and five years of experience in a clinical practice setting. Preferred experience includes public health settings or clinical experience delivering care to Medicaid populations in a Federally Qualified Health Center or private practice and/or previous experience within the dental insurance industry or state administration experience. Expert knowledge of dental terminology, procedures, oral health education programs, utilization management, dental benefit administration, data collection, data analysis methodology, and performance improvement methods is required. Strong verbal and written communication skills, interpersonal skills, and analytical skills are essential. Ability to lead and motivate others, analyze and resolve highly complex problems using independent judgment is required. Position requires travel 10‑25% throughout the state of Tennessee and nationally as necessary. Equal Employment Opportunity
Delta Dental of Michigan, Delta Dental of Ohio, and Delta Dental of Indiana 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.
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Location: Nashville, TN. Salary: $185,000 - $325,000. Job Summary
Supports oversight of clinical integrity, quality, and efficiency of dental services under the Tennessee Medicaid dental insurance program and ensures all dental care delivered meets highest standards and complies with federal and state regulations. Primary Responsibilities
Supports the oversight of clinical operations to ensure delivery of high‑quality dental care in compliance with all applicable standards and in support of the Delta Dental Utilization Management Program Plan. Participates in the development and implementation of quality assurance initiatives. Monitors and evaluates clinical performance metrics to ensure continuous improvement in service delivery. Conducts regular audits and reviews of clinical services to ensure quality and compliance with contractual guidelines and requirements. Provides clinical guidance and support to network dental providers to enhance patient care quality. Develops and facilitates provider education and training programs to promote adherence to clinical guidelines and Medicaid policies. Supports the development and implementation of innovative programs to enhance access to care and improve health outcomes. Stays informed about changes in Medicaid policies and updates clinical practices accordingly to ensure compliance with all federal and state regulations and nationally recognized quality standards. Promotes patient‑centered care and support initiatives that enhance patient education and engagement. Collaborates with community organizations and stakeholders through regular meetings and attendance at community events to promote benefit awareness, oral health education and preventive care. Reviews and adjudicates prior authorizations and retrospective claims submitted by providers in accordance with company utilization management standards, clinical policies and Medicaid guidelines. Minimum Requirements
Position requires a D.D.S. or D.M.D. from an accredited school of dentistry, an unrestricted license to practice dentistry in Tennessee, and five years of experience in a clinical practice setting. Preferred experience includes public health settings or clinical experience delivering care to Medicaid populations in a Federally Qualified Health Center or private practice and/or previous experience within the dental insurance industry or state administration experience. Expert knowledge of dental terminology, procedures, oral health education programs, utilization management, dental benefit administration, data collection, data analysis methodology, and performance improvement methods is required. Strong verbal and written communication skills, interpersonal skills, and analytical skills are essential. Ability to lead and motivate others, analyze and resolve highly complex problems using independent judgment is required. Position requires travel 10‑25% throughout the state of Tennessee and nationally as necessary. Equal Employment Opportunity
Delta Dental of Michigan, Delta Dental of Ohio, and Delta Dental of Indiana 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.
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