Dental Case Manager

5 days ago

Roseville, United States Gainwell Technologies LLC Full time
About the Role

We are seeking a highly skilled Dental Case Manager to join our team at Gainwell Technologies LLC. As a key member of our healthcare team, you will play a vital role in ensuring the delivery of high-quality healthcare services to our clients.

Your primary responsibility will be to intake and evaluate members for case management, collaborating with a multi-disciplinary team to perform risk assessments, implement, and monitor plans of care. You will also schedule and coordinate complex treatment plans involving dental and medical providers, making referrals to appropriate clinical specialists as needed.

Additionally, you will obtain authorizations and approvals for medically necessary dental care, assist with obtaining supporting ancillary services, and monitor members' adherence to treatment, appointments, and receipt of care. You will update and adjust plans of care as needed, recording case information and accurately completing all necessary forms and producing statistical reports as required.

Requirements

To be successful in this role, you will need to have a proven work experience in Case Management, with a minimum of three to five years of experience in a relevant Case Management position in the healthcare or insurance industry. Medicaid and/or Medicare knowledge and experience are strongly desired.

You will also need to have previous lead or management experience in monitoring performance standards of a team and supporting client escalations. Clinical and/or Dental health experience is preferred, as is strong knowledge of dental treatment authorization request processes, procedures, and documentation.

Other essential skills include the ability to work with others and use resources to problem-solve, apply good judgment to fast-changing situations, and possess effective verbal and written communication skills, exceptional interpersonal, customer service, negotiation, and problem-solving skills.

What We Offer

As a valued member of our team, you can expect to work in a hybrid environment, with the option to work from home 2-3 days a week. You will be based in Roseville, CA, and must be a resident of California. We offer a dynamic and supportive work environment, with opportunities for growth and professional development.

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