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Dental Medical Reviewer - PRN (Remote U.S. with Arkansas License)
Company Overview<br><br><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.</span></p> <br>Job Summary and Responsibilities<br><br><p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;"><strong><span style="color: #000000;">Acentra Health is seeking a Dental Medical Reviewer - PRN (Remote U.S.)</span></strong></span></p><p> </p><p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;"><strong><span style="color: #000000;">Job Summary:</span></strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;"><span style="color: #000000;">The Dental Physician Reviewer will o</span>versee utilization review/management activities to include peer review, utilization review, fair hearings and appeals, and other clinical consultations and support the dental Utilization Management (UM) contract for Arkansas.</span></li></ul><p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;"><strong>Responsibilities:</strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;">Collaborate with the Medical and/or Dental Director on case consultations as needed.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;">Discuss complicated Utilization Management reviews or clinical scenarios with Utilization Management Dental Hygienist Reviewers.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;">Review safety, sentinel, and Quality of Care events and provide detailed feedback and recommendations as per organization and policy.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;">Complete all secondary-level Dental Utilization Management reviews.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; background-color: #ffffff;">Participate in and provide feedback for an annual review of clinical medical necessity criteria.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; color: #000000; background-color: #ffffff;">Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.</span></li></ul><p><em><strong><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt; color: #000000; background-color: #ffffff;">** This PRN role requires scheduling flexibility, including availability for some evenings and weekends. Specific workdays and hours will be discussed during the interview process. **</span></strong></em></p> <br>Qualifications<br><br><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>Required Qualifications/Experience:</strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Doctor of Medicine in Dentistry (DMD) or Doctor of Dental Surgery (DDS) degree from an accredited dental school.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">An active Arkansas Dental License issued by the <strong>Arkansas State Board of Dental Examiners (ASBDE).</strong></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><a>10+ years of clinical practice.</a></span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">1+ years of experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare programs.</span></li></ul><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>Preferred Qualifications/Experience:</strong></span></p><ul><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Demonstrated proficiency in Microsoft Office applications.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Excellent written and verbal communication skills.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Consistently maintains a professional demeanor and presence.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Strong team player with a proven ability to collaborate in dynamic, team-oriented environments.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">In-depth understanding of quality assurance processes and utilization review practices.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Knowledgeable about key trends and developments in healthcare and managed care.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Skilled at working effectively with individuals of diverse backgrounds and personalities.</span></li><li><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Flexible and resilient in the face of shifting priorities and evolving work environments.</span></li></ul><p><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">#LI-SD1 </span></p><p> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>Why us?</strong></span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>We do this through our people.</strong></span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>Thank You!</strong></span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">~ The Acentra Health Talent Acquisition Team</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Visit us at <a href="https://careers.acentra.com/jobs" target="_blank" rel="noopener" aria-label="Link Acentra Health">Acentra Health</a> </span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>EEO AA M/F/Vet/Disability</strong></span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong>Compensation</strong></span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;">The pay for this position is listed below.</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: 10pt;"><strong><em>"Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."</em></strong></span></p> <br>Pay Range<br><br>USD $115.00 - USD $0.00 /Hr.