13 Mar 2020

Full-Time Dental Consultant, MassHealth BOH

RecruitDQ – Posted by RecruitDQ Boston, Massachusetts, United States

Job Description

JOB SUMMARY: The Dental Consultant, MassHealth Board of Hearings is the assigned representative of decisions for coverage made by DentaQuest as the third-party administrator on behalf of the MassHealth Dental Program at the Massachusetts Board of Hearings.

PRIMARY JOB RESPONSIBILITIES:

  • Work with the DentaQuest MassHealth team to schedule hearings for members who have appealed to the Massachusetts Board of Hearings.
  • Prepare a thorough review of each appealed case, including discussion with DentaQuest’s Dental Consultants.
  • Represent DentaQuest [and MassHealth] with respect to the decision at each hearing.
  • Work collaboratively with the MassHealth / DentaQuest 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 and decisions and communicate the same 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 JOB

QUALIFICATIONS:

Required:

  • Dental Provider / Specialist who is board certified or board eligible and graduated from a Commission on Dental Accreditation approved program.
  • 10 years’ experience in practice as a licensed 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.

Preferred:

  • Orthodontic license not required, but preferred.

PHYSICAL DEMANDS:

  • 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 Apply

To be considered for this role, please apply here: http://gr.8job.co/blH4sps0

Job Categories: Equal Opportunities. Job Types: Full-Time.

Job expires in 70 days.

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