Arkansas, USA
4 days ago
Dental Reviewer, Supervisor (Remote within Arkansas)

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. 

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. 

Acentra is looking for a Supervisor, Dental Review (Remote within Arkansas) to join our growing team.

Job Summary:

Under the general supervision of the Program Director and in collaboration with the Clinical Director and Medical Director, the Supervisor, Dental Review oversees dental staff performing Utilization Management (UM) Reviews for Medicaid Members in accordance with the goals of the Arkansas Department of Human Services Performance-based Contract with Acentra Health. The selected candidate plans, organizes, and directs the work activity of the review team, consistent with organizational policies and procedures and in compliance with state and federal guidelines, along with performing UM Reviews when necessary to ensure compliance.

Job Responsibilities:

Assure accuracy and timeliness of all dental reviews within contract requirements. Assess, evaluate, and address daily workload and review queues; adjust work schedules daily to meet the workload demands of the department. Analyze the productivity of reviewers. Identify clinical staff orientation and continuous learning needs and, in collaboration with the Clinical Director and Program Director, develop and implement plans to address those identified learning needs. Perform Annual Performance review of direct reports. In collaboration with the Program Director, responsible for the quality monitoring activities, including identifying areas of improvement and plan implementation of improvement areas. Maintain current knowledge base related to review processes and clinical practices related to the processes and functions as the initial resource to assigned clinical staff regarding all review process questions and/or concerns. Perform all applicable review types as workload indicates. Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process. Attend training and scheduled meetings for maintenance and use of current/updated information for review. Cross trains to perform duties of other contracts within Acentra Health to provide a flexible workforce to meet client/customer needs.

The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

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