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Dental Director

at Delta Dental of Idaho in Boise, Idaho, United States

Job Description

Delta Dental of Idaho seeks a dentist to join our management team to help ensure our business maintains a strong focus on the dental profession, incorporates clinical expertise as plans and strategies are developed, and maintains our strong relationship with the dental community. Your knowledge and expertise as a dentist will strengthen our ability to meet our mission, which focuses on the power of oral health to enrich lives.

General Description

The Dental Director provides expert dental opinion, advice and counsel to the Dental Advisory Committee and the organization regarding claim processing policies, utilization management, the fraud, waste and abuse program, as well as input on product development. In addition, the Dental Director oversees the Professional Relations function and staff, and serves as a liaison between DDID and the dental professionals within the state of Idaho. This is a 30-hour per week, benefitted position, and the ideal candidate will also be a practicing dentist on a part-time basis.

ESSENTIAL FUNCTIONS

Professional Relations

  • Oversees the Professional Relations team focused on strengthening relations with our network dentists. Establishes goals and priorities with team members, consistent with organizational strategies.
  • Represents Delta Dental with dental professional societies and associations. Advocates for DDID before the dentist membership. Meets with dentists, academics, clinicians, and hygienists on an as-needed basis.
  • Serves as a point of contact for dentists and keeps leadership apprised of issues/concerns.
  • Provides input to the development of provider networks, including recruiting, credentialing, and retention activities.

Dental Claim Processing Policies

  • Provides oversight of claim review process utilizing current policies/guidelines/standards, DeltaUSA processing policies, provider agreements, and state law applicable to claims adjudication.
  • Oversees the research and follow up of concerns expressed from dentists and patients regarding dental procedures and claims processing policies.

Fraud Waste and Abuse

  • Oversee the research and analysis of dental practice patterns, fraud and abuse monitoring and on-site dental office audits.
  • Coordinates dental consultant activities, oversees claim reviews, and provides clinical expertise for the Department of Insurance appeals process and post-treatment review.

Products

  • Provides input and advice on oral health products/services/consumables offered by Delta Dental or subsidiaries
  • Review dental claims utilization, risk assessment data, and current dental practices, making recommendations to leadership as appropriate (technology, process, plan changes, etc.).

General

  • Identify emerging technologies and trends in the dental industry and provide analysis and recommendation to the organization.
  • Represent DDID in national and Delta member company lead initiatives for value based care/measures.
  • Acts as the “voice of the dentist,” providing input and guidance to activites/projects/initiatives impacting our network dentists
  • Responsible for the preparation and adherence to the departmental budget. Monitors actual to budget performance, analyzes variances and implements strategies to meet budget.
  • Demonstrate a commitment to the organization’s vision, mission, values, code of ethics, and compliance/security standards.
  • Other duties as assigned.

Requirements

QUALIFICATIONS, KNOWLEDGE, SKILLS, AND ABILITIES

  • Three or more years of experience performing dentistry.
  • Active/current license to practice dentistry in Idaho; preferably still actively performing dentistry in Idaho (i.e., part-time basis).
  • DDS or DMD degree from an accredited college of dentistry.
  • Knowledge of modern dental science practices, utilization review techniques, data/statistical analysis, practice protocols, and ADA issues.
  • Knowledge and experience with general business principles and practices preferred.
  • Minimum of two years of personnel management experience and knowledge of effective supervisory/management practices.
  • Tech-savvy with experience in applying technology/software to improve processes.
  • Familiarity with dental quality assurance programs, oral health risk assessments, evidence-based community interventions and the critia and standards used to monitor and measure patient outcomes preferred.
  • Strong skills, abilities and commitment to teamwork, customer service and dependability.
  • Ability to travel (if applicable—mainly for Community Outreach, Sales, Oral Health).

 

Note that all individuals hired after August 17, 2021 are required to show proof of vaccination against COVID-19 prior to starting work unless the Company approves an exemption for either medical or religious reasons. Vaccination status will only be reviewed following an offer of employment.

 

PHYSICAL AND MENTAL REQUIREMENTS

  • Sitting/Standing (alternatively) continuously
  • Keyboard Use/Repetitive Hand motion continuously
  • High level of skills related to comprehension, organization, reasoning/decision-making and communication.

 

Benefits

Competitive salary and benefits package, including paid medical, dental, vision, life, and disability insurance, as well as a generous 401k plan, among other benefits.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

EOE/M/F/Vet Disability

Individuals that may need assistance with the applicant or interview process may contact Delta Dental of Idaho at hr@deltadentalid.com or by phone: 208-488-7718.

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Job Posting: 1570951

Posted On: Oct 04, 2021

Updated On: Nov 04, 2021