Oral Health Care Consultant
7 days ago
Acentra Health is seeking a highly skilled Oral Surgeon Dental Specialist to join our team. As a key member of our organization, you will play a critical role in ensuring the delivery of high-quality health outcomes through technology, services, and clinical expertise.
Key Responsibilities- Oversee utilization review/management activities, including peer review, utilization review, fair hearings, and appeals, as well as other clinical consultations related to the applicable contract.
- Support the dental UM contract for Arkansas Medicaid, collaborating with the Medical Director and other Dental Physician Reviewers as needed.
- Discuss complicated Utilization Management reviews or clinical scenarios with Utilization Management Dental Hygienist Reviewers.
- Review safety, sentinel, and Quality of Care events, providing detailed feedback and recommendations as per organization and policy.
- Complete all secondary-level Dental/Oral Surgeon Utilization Management reviews.
- Develop and complete an annual review of clinical medical necessity criteria.
- Travel in-state as needed for client-requested meetings or in-services (minimal travel required).
- DMD or DDS from an accredited dental school.
- Completion of an accredited US Oral Surgery Residency Program.
- Active Arkansas dental license.
- Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare programs.
- Prior review experience or quality assurance committee responsibility preferred.
- Proficient in Microsoft Excel and other Microsoft Office applications.
- Exceptional writing and oral communication abilities.
- Strong knowledge of quality assurance and utilization review.
- Ability to work remotely.
- Ability to work effectively with a diversity of personalities.
- Ability to be a creative thinker.
Acentra Health is a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. We are a vital partner to state and federal healthcare agencies, providers, and employers, ensuring better healthcare and improving health outcomes.
We offer a comprehensive benefits package, including health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. We are an Equal Opportunity Employer and welcome applications from all qualified candidates.
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