Dental Consultant, MassHealth Board of Hearings
Location: Boston, Massachusetts, United States
Remote Opportunity: 1
Requisition Number: 2096
Position Title: 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.
Community / Marketing Title: Dental Consultant, MassHealth Board of Hearings
At DentaQuest, we believe that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system – from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.
Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.
To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and delivering measurable outcomes for the people we serve.
The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.
Location_formattedLocationLong: Boston, Massachusetts US
CountryEEOText_Description: Equal Employment Opportunity Statement: DentaQuest is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, sex, age, disability, marital status, or sexual orientation.