Job Title:

Dental Case Management Director

Number of Positions:

1

Location:

DDMI_Tennessee

Location Specifics:

Hybrid Position

Job Summary:

Must reside in Metropolitan Davidson County, Tennessee or a county contiguous to Metropolitan Davidson County, Tennessee.

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities for all. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation.

At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

#LI-Hybrid

Position Description:

Oversees the development, implementation, and ongoing coordination of case management programs aimed at improving dental care outcomes for Medicaid beneficiaries.

Primary Job Responsibilities:

• Develops and implements comprehensive dental case management programs to support Medicaid beneficiaries.

• Establishes policies and procedures for effective case management and ensures all activities comply with federal and state Medicaid guidelines.

• Monitors program performance and makes adjustments to enhance efficiency and outcomes.

• Interviews, hires, trains, develops, and evaluates staff to ensure accountability for the achievement of departmental goals and objectives.

• Manages and evaluates departmental activities to ensure continuous improvement of the care coordinators programs and services.

• Oversees the coordination of care for high-risk and complex patients, ensuring they receive appropriate and timely dental services.

• Facilitates communication between patients, dental providers, MCOs and other healthcare professionals to ensure continuity of care.

• Oversees the development and distribution of educational materials and other communications to subscribers and dental provider offices.

• Conducts regular audits and implements quality assurance initiatives to monitor and ensure compliance and improve case management services.

• Provides education and support to patients to help them understand and navigate their dental benefits.

• Analyzes case management data to identify trends, outcomes, and areas for improvement.

• Prepares and present regular reports to senior leadership on program performance and impact.

• Provides support to Dental Case Managers as needed with case management, event coordination and attendance, as well as other job duties to achieve contractual performance metrics.

Minimum Requirements:

Position requires a bachelor’s degree in business administration or healthcare administration, or a related field and five years of experience in a position requiring advanced knowledge of dental terminology, dental procedures, appropriate dental care, oral health education programs, and/or dental education programs, and two years of leadership experience. Previous experience counseling or educating individual patients and/or the general public regarding the importance of good oral hygiene habits, conducting dental research or data collection and analysis, or designing or administering a public health program or dental education program is preferred. Previous experience in a dental office setting, clinical dental and/or public health is also preferred. Will accept any suitable combination of education, training, or experience.

Position requires advanced knowledge of dental terminology, dental procedure codes, appropriate dental care, and the claims adjudication process; care coordination planning, implementation, analysis and reporting skills; strong analytical skills; knowledge of word processing, spreadsheet, and database applications; strong verbal and written communication skills; the ability to represent and present on behalf of the organization, both internally and externally; the ability to work independently and as part of a team; the ability to manage multiple projects with competing deadlines; and the ability to resolve complex problems and use independent judgment.

Position requires travel of 10-25% throughout the state of Tennessee, and nationally as necessary.

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance.