The Cigna Group

East Regional Dental Director

The Cigna Group

full-time

Posted on:

Location Type: Remote

Location: Remote • 🇺🇸 United States

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Salary

💰 $150,100 - $250,100 per year

Job Level

Lead

About the role

  • Provide clinical leadership and support at the regional level
  • Manage effective DHMO and PPO Quality Management Programs (QMPs) at the regional level
  • Work directly with dental health care professionals to address issues, as appropriate
  • Act as clinical lead on customer and provider complaints and appeals, as requested
  • Manage the development of corrective actions at the member and provider level for quality-of-care grievances in the region
  • Coordinate with professional relations and services to resolve provider issues
  • Participate in state audits as the state Dental Director
  • Ensure effective provider monitoring including Performance Monitoring, regional Grievance Subcommittee, regional Utilization Management Subcommittee, and regional Peer Review Subcommittee activities
  • Maximize sales opportunities and results through participation in finalist, renewal presentations, broker meetings, open enrollments, and health fairs
  • Participate in projects and workgroups to enhance product/program offerings to customers
  • Assist Clinical Leadership in the development and maintenance of national policies and guidelines

Requirements

  • Must maintain an active dental license (DDS or DMD) to practice dentistry
  • At least 3 years’ experience as a Dental Director with a healthcare insurer
  • Minimum 5 years of experience in clinical practice
  • ADA membership is preferred
  • Must be detail oriented, highly organized, deadline driven, and self-motivated
  • Must possess project management expertise with demonstrated experience in managing multiple projects and priorities
  • Excellent interpersonal skills. Capable of working and communicating well in a matrixed environment
  • Excellent oral and written communication skills are required
  • Experience managing team members
  • Skilled in the use of Microsoft Word, Excel, PowerPoint, and Outlook
  • Capable of quickly learning and mastering the intricacies of a variety of IT systems
  • Experience in the various aspects of a strong Quality Management Program
  • Strong background in the Credentialing and Re-credentialing of dentists
  • Excellent analytical, quantitative, and problem-solving skills
  • Knowledge of NCQA, DQA and other medical/dental quality standards and state specific regulations regarding quality programs
  • Command of dental terminology, clinical procedures, and benefit language
  • Financial acumen for assisting in financial analysis
  • Demonstrates an ability to analyze financial data
  • Demonstrates the ability to work collaboratively to resolve conflicts
  • Excellent public speaking and presentation skills, matrix management and collaborative teamwork experience preferred
  • Have the ability to handle multiple, new, and unanticipated responsibilities that arise as a result of tactical and strategic planning
Benefits
  • medical
  • vision
  • dental
  • well-being and behavioral health programs
  • 401(k) with company match
  • company paid life insurance
  • tuition reimbursement
  • a minimum of 18 days of paid time off per year and paid holidays

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
Dental DirectorQuality Management ProgramCredentialingRe-credentialingProject managementFinancial analysisAnalytical skillsProblem-solvingClinical practiceDental terminology
Soft skills
Detail orientedHighly organizedDeadline drivenSelf-motivatedInterpersonal skillsOral communicationWritten communicationCollaborative teamworkPublic speakingConflict resolution
Certifications
Dental license (DDS or DMD)ADA membership