Dental Director

DELTA DENTAL OF VIRGINIA•Roanoke, VA

7h•Hybrid

About The Position

The Dental Director provides strategic and operational leadership over Delta Dental of Virginia’s dental policy. Reporting directly to the Chief Operating Officer while serving as a critical partner to a Chief Dental Officer, the Dental Director provides leadership over the team of Dental Consultants who collectively ensures that clinical policies, coding guidance, interpretations, use of artificial intelligence and other supporting technologies, and utilization practices align with organizational standards and strategy, as well external regulatory requirements and industry best practices. This role serves as the primary internal clinical authority and external liaison to the dental community within Virginia, while advancing innovation initiatives such as AI, quality improvement, and maintaining system-wide alignment across various internal and external stakeholders, departments, and the Executive Leadership Team. As a critical member of the leadership team at Delta Dental of Virginia, this role will lead new cross-functional special projects and strategic initiatives, which may require performing and facilitating other duties or tasks as needed or assigned.

Requirements

A degree from an accredited U.S. College of Dentistry (DMD or DDS) with a current dental license or eligibility for Virginia license to practice dentistry.
Minimum of 5 years dental practice experience.
An insignificant malpractice history.
Depth of understanding of the dental insurance industry, including: Familiarity with dental claims and the review process from the dentist and carrier side, Knowledge of CDT codes, or the ability to quickly develop proficiency in dental policy requirements, Familiarity with industry and dental economic trends.
Evidence of regular Continuing Education course completion.
Familiarity with current dental science, utilization review techniques, data/statistical analysis, practice protocols and ADA issues.
Ability to analyze data and make effective decisions.
Knowledge and understanding of healthcare insurance products, dental industry trends, and the administrative delivery of group products desirable.
Strong interpersonal and communication, leadership, and team development skills.
Demonstrated experience leading people and getting results through others.
A strong team player, comfortable working collaboratively, virtually, and independently.
Advanced proficiency with computer programs including the MS Office suite, Claims Processing software, and/or generative AI tools (CoPilot, etc.).

Nice To Haves

Two or more years of dental consulting experience preferred.
Management or Consulting experience preferred.

Responsibilities

Serve as a strategic partner to the organization on all clinical initiatives impacting DDVA and affiliated markets.
Provide leadership, subject matter expertise, and maintain contractual and clinical relationships to advance enterprise initiatives related to: AI-enabled claims review and automation, Technical innovation, Product development, Clinical programs and innovation.
Identify emerging technologies and trends in dentistry and recommend strategic responses.
Maintain deep working knowledge of DeltaUSA policies and DDPA standards.
Lead the internal interpretation and application of clinical processing policies.
Oversee CDT code review and implementation, including: Review of proposed code changes, Participation in external industry forums (e.g., DDPA, AHIP), Recommendations for coverage and pricing (in collaboration with Underwriting and leadership), Coordination of system configuration and internal policy updates, Updates to Dentist Handbook and related communications.
Ensure internal alignment and clarity regarding clinical rules and benefit interpretations.
Research and recommend market-leading processing policies to maintain Delta Dental of Virginia’s competitive positioning.
Responsible for the recruitment, training, management, and maintaining strategic alignment of team consisting of part-time dental consultants.
Establish performance expectations, identify performance metrics and track performance and provide coaching and feedback.
Lead consultant calibration sessions to ensure consistency in clinical decision-making.
Support professional development and continuing education within the clinical team.
Support and advance a comprehensive utilization management strategy.
Analyze utilization trends, dental outcomes, and practice patterns to inform policy recommendations.
Review utilization data, dental outcomes and current dental practices to help determine payment policy. Makes recommendations to the Chief Dental Officer and department head over the Clinical Professional Services team.
Lead or refine the organization’s Quality Management program, including: Quality Plan and Work Plan development, Annual program evaluation, Quality Management Committee leadership and reporting.
Partner with Reporting & Business Intelligence team to develop meaningful performance reporting.
Identify opportunities to improve health outcomes and align dental benefits with evidence-based practices.
Build and maintain strong relationships with national and statewide participating dentists and professional societies.
Support network recruitment, credentialing, retention, and fee schedule review.
Lead or participate in Credentialing Committee meetings and peer review processes.
Act as spokesperson on clinical and policy matters when appropriate.
Represent Delta Dental of Virginia with professional societies, associations, academic institutions, and the national Delta Dental Plans Association.
Serve as the spokesperson to the marketplace, the profession and subscribers on the value of appropriate dental care and treatment.
Support Foundation initiatives and community oral health partnerships.