Dental Orthodontist Physician Reviewer

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise.

Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company;

to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities.

In fact, you have all you need to take charge of your career and accelerate better outcomes making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra is looking for a to join our growing team.

Job Summary :

The Dental Physician Reviewer-Orthodontist will oversee utilization review / management activities to include peer review, utilization review, fair hearings and appeals, and other clinical consultations related to the applicable contract.

The Dental Orthodontics Physician Reviewer will support the dental UM contract for Arkansas Medicaid.

Job Responsibilities :

• Collaborate with Medical Director and other Dental Physician Reviewers on case consultations s 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 / Orthodontia 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).
• Perform any other duties assigned.

Requirements

Required Qualifications / Experience

• DMD or DDS from accredited dental school.
• Completion of an orthodontic residency program.
• Active Arkansas orthodontic dental license.
• 10+ years of clinical practice preferred.
• Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare programs.
• Proficient in Microsoft Excel and other Microsoft Office applications.
• Exceptional writing and oral communication abilities.
• Maintain a professional manner and demeanor.
• Able to collaborate effectively with team members and thrive in a collaborative work environment.
• Strong knowledge of quality assurance and utilization review.
• Ability to work remotely
• Ability to work effectively with a diversity of personalities.
• Ability to be approachable, show respect for others and be a consensus builder.
• Strong organizational skills and a system thinking approach.
• Ability to deliver on time and within budget.
• Ability to be a creative thinker.
• Possess high energy and enthusiasm.
• Able to adapt to frequently changing work parameters.

Preferred Qualifications / Experience :

Prior review experience or quality assurance committee responsibility preferred.

Benefits

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry.

State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work.

Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is

Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted.

We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest.

Best of luck in your search!

The Acentra Health Talent Acquisition Team

Visit us at Acentra.com / careers /

EOE AA M / F / Vet / Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.