Full-Time Dental Advisor
PRIMARY JOB RESPONSIBILITIES:
Work with the DentaQuest MassHealth team to attend scheduled hearings for members who have appealed to the Massachusetts Board of Hearings.
Prepare a thorough review of the prior authorization decision, state regulations and the office reference manual for each appealed case prior to hearing.
Represent DentaQuest [and MassHealth] with respect to the decision determined in compliance with state regulations at each hearing.
Work collaboratively with the MassHealth / DentaQuest dental consultant team supporting the Massachusetts Board of Hearings to ensure consistency in the application of the rules and regulations established by MassHealth for the plan regarding the decisions made for coverage.
Document hearing interactions / decisions and communicate to the MassHealth DentaQuest team for tracking and appropriate action.
Attend quarterly meetings with the MassHealth team at DentaQuest and complete online training as needed.
Other duties as assigned
Dental Provider / Specialist who is board certified in orthodontics or board eligible and graduated from a Commission on Dental Accreditation approved program.
10 years’ experience in practice as a licensed orthodontic dental provider in Massachusetts.
Ability to provide transportation to and attend hearings at any location deemed necessary per the schedule from the Massachusetts Board of Hearings.
Excellent oral and written communication skills.
Efficient PC skills (Word, Excel, PowerPoint).
Ability to work as a team member.
Required to attend additional training as requested/deemed necessary. ( I fixed spacing issues between the second to last and last bullet)
Massachusetts active dental license in good standing required.
Incumbent must be able to communicate effectively.
Requires overall light physical effort (up to 25lbs.)
Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer).
Ability to travel or move about within and outside serviced facilities required.
Incumbent works primarily in either a private or shared office environment.
How to Applyhttp://gr.8job.co/nnjlqRUE
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