DENTAL CONSULTANT

Delta Dental of California is the state’s largest dental health plan. Along with its affiliates, the nonprofit corporation covers over 17 million people in its commercial and government programs throughout California and 19.7 million throughout the nation. It is part of a national holding company system formed with Delta Dental of Pennsylvania and its affiliates. Together, the holding company members represent one of the largest dental benefits systems in the country, with 23 million enrollees.

 

We are looking for two full-time, motivated, self-starter Dental Consultants to be responsible for reviewing claims and treatment plans determining appropriateness of treatment as relates to contracts, policy and dental standards of practice; discussing claim adjudication decisions with dental offices upon request; administering enrollee quality of care complaints protocols and operational procedures; reviewing, resolving and documenting enrollee and provider complaints and other issues involving clinical quality of care; assisting in identifying trends, educational needs and corrective actions related to the structure and delivery of care by participating dentists; evaluating coverage, necessity and appropriateness of dental treatment for patients covered by Delta programs; acting as liaison to outside entities such as California Association of Dental Plans, California Dental Association and Department of Managed Health Care (DMHC) involving quality of care programs and/or other issues relating to compliance with laws and regulations.

Ideal candidate must have:

 

v  DDS or DMD degree.

v  Seven years clinical experience in Dentistry.

v  An active and unencumbered California dental license.

v  PC literacy in WORD and EXCEL.

v  Knowledge of Delta’s contracts, policies and procedures.

v  Ability to understand and analyze complex provider statistics and data, determine trends, identify aberrant dental practices and utilization patterns.

v  Excellent written and oral communication skills.

v  Excellent organizational and planning skills.

v  Ability to handle various and changing priorities as dictated by the business environment.

v  Ability to travel throughout the United States.

 

We offer a competitive salary and comprehensive benefit package (most is fully paid by the Company) for employees and eligible dependents.

 

To apply, send resume with reference # IRC14700 to recruit@delta.org or go to http://www.deltadentalins.com and click on 'CAREERS' to apply online.

 

In connection with your application for employment with Delta Dental of California and its related companies, please note that any offer of employment made to any applicant will be contingent upon the satisfactory results of a background check. Such background check may include, but is not limited to, an investigation of credit worthiness, a check of references, employment and education verification, a check of criminal records and/or any other investigations as permitted by law.

 

EOE/AA