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Oral Surgeon Dental Specialist
2 months ago
Acentra Health is seeking a highly skilled Oral Surgeon Dental Reviewer to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring the highest quality of care for our clients.
Key Responsibilities- Oversee utilization review/management activities, including peer review, utilization review, fair hearings and appeals, and other clinical consultations related to the applicable contract.
- Support the dental UM contract for Arkansas Medicaid.
- Collaborate with Medical Director and other Dental Physician Reviewers on case consultations as needed.
- Discuss complicated Utilization Management reviews or clinical scenarios with Utilization Management Dental Hygienist Reviewers.
- Review safety, sentinel, and Quality of Care events and provide 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 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 leading provider of health solutions, empowering better health outcomes through technology, services, and clinical expertise. Our team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals come together to redefine expectations for the healthcare industry.
We are a vital partner for health solutions in the public sector, working with state and federal healthcare agencies, providers, and employers to ensure better healthcare and improve health outcomes.
Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.