Medical Director
Centene Corporation
Clinical Director – Dental
Centene Corporation
part-time
Posted on:
Location Type: Remote
Location: Remote • Illinois • 🇺🇸 United States
Visit company websiteSalary
💰 $165,400 - $314,200 per year
Job Level
Lead
About the role
- Provide professional judgment to adjudicate prior authorization, claims, and appeals submissions
- Help create, implement, and carry out dental clinical policy consistent with ADA and specialty guidelines
- Review and decision prior authorization and claim submissions
- Review and decision member and provider appeals
- Participate on committees as requested
- Develop and evaluate clinical policies
- Provide guidance and subject matter expertise to health plans
- Provide clinical specialty guidance to dental leadership
- Performs other duties as assigned
- Complies with all policies and standards
Requirements
- DDS/DMD degree required
- 5 years of experience in dental claims and knowledge of dental or orthodontic care
- License/Certification: DDS or DDM degree and valid dental license
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- a flexible approach to work with remote, hybrid, field or office work schedules
- Total compensation may also include additional forms of incentives
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
adjudicationprior authorizationclaims processingappeals managementclinical policy developmentclinical evaluationsubject matter expertisedental care knowledgeorthodontic care knowledge
Soft skills
professional judgmentguidancecommunicationcollaborationleadership
Certifications
DDSDMDvalid dental license
