Utilization Management Reviewer - Dental Hygienist

A-Line Staffing is now hiring Utilization Management Reviewer - DentalHygienist in Indianapolis, IN 46204. The Utilization Management Reviewer - Dental Hygienistwould be working for a Major Health Plan and has career growth potential.
Utilization Management Reviewer - Dental Hygienist Highlights:

• Hybrid role: Mostly remote – in office once a week, then expect once a month for making off site visits to health centers/providers.
• Mon-Fri 8am-5pm EST
• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with a company match is available for full-time employees with 1 year of service on our eligibility dates
• Pay Range: $35 - $45 Hourly (plus mileage reimbursement)

Utilization Management Reviewer - Dental Hygienist Responsibilities:

• Monthly reviewing of SLT report and assessment of dental HEDIS measures.
• Dedicated outreach to members with care gaps. Aid members experiencing SDoH to connect with providers/locations.
• Monthly review and education for members with ED visits for dental pain. Attend DAC and DTF meetings.
• Performance expectations/metrics: Number of calls made to HCs and members. Number of visits to HCs. Number of referrals made to providers. Timely preparation of reports. Upward movement of percentage care gap closure

Utilization Management Reviewer - Dental Hygienist Requirements:

• Minimum two years in clinical dental practice.
• High School diploma or GED required.
• Strong communication/ listening skills; problem solver.
• Data analysis.
• Software Skills Required: Word, Excel.

Utilization Management Reviewer - Dental Hygienist Preferments:

• 5 years in clinical practice, including FQHC, or RHC
• Proficient in Spanish
• Motivational interviewing
• Dental hygiene degree/certificate

If you are interested in this Utilization Management Reviewer - Dental Hygienist position, please apply to this posting with Chris Meyer at A-Line!
Keywords: dental, Dental Hygienist, registered Dental Hygienist, certified Dental Hygienist, Utilization Management, utilization review, concurrent review, retrospective review, prospective review, appeals, denials, grievances, claims, HEDIS, STARS, gap closure, care gaps, fieldwork, managed care, MCO, CMS, Medicaid, Medicare, EMR, Electronic Medical Records system