Sr Dental Consultant

Dearborn Group•Lombard, IL

15d

About The Position

At Dearborn, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This highly technical and critical position is responsible for the clinical integrity, accuracy and consistency of DNoA’s dental claims review process. This role will be of particular importance, given DNoA’s commitment to increase the efficiency and focus of the current review process. The Sr Dental Consultant will assume a critical role in the implementation and oversight of this enhanced review process. Reporting to the Executive Dental Director, they will work with all stakeholders to develop a vision for Dental Blue that is clinically sound, market leading and reflective of current scientific research and clinical practice. In addition to the review of complex claims and appeals, this individual will be a key contributor to the assessment and implementation of new clinical policy; at the detailed level of policy logic and decision-tree development. These clinical rules, driving the application of medical necessity determinations and contractual compliance, will be applicable across all corporate divisions of HCSC.

Requirements

DDS or DMD degree.
A minimum of five years of clinical practice experience
Current, unrestricted clinical license, and ability to provide updated license annually.
Eligible for certification by the American Association of Dental Consultants.
Excellent verbal and written presentation skills.
Demonstrated ability to work in a team environment.
Flexibility to accommodate changes in business priorities.
Demonstrated ability to promote a culture of constant growth, learning and improvement.