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| Employer Name: DentalCrossing |
SpiderID: 2339758 |
| Location: Baltimore, Maryland |
Date Posted: 7/4/2008 |
| Wage: |
Category: Healthcare |
| Job Code: 4649441 |
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Job Description:
The incumbent establishes oral health care medical policies, dental plan benefits, and claims administration policies, dental contract provisions, dental access standards and provider network strategy, dental provider allowance strategy and allowance determination, and community program development oversight. Responsible for all dental utilization management and review initiatives and functions for all lines of medical and dental businesses. Represents CareFirst in professional relations activities with community dentists. Participates with marketing, operations, and sales entities to develop dental business initiatives, enhance product design, and improve sales. Completes and oversees dental plan professional claims review, including supervision of dental consultants. Represents CareFirst in legal challenges involving dental claims. Completes medical plan professional claims reviews, pre-certification determinations, adverse decision appeals, quality improvement actions. Establishes network access standards and determines dental plan provider allowances to assure competitive rates and maintain adequate networks. Qualifications: Must be licensed to practice dentistry in the State of Maryland and be an active participant in organized dentistry. Requires a thorough knowledge of oral health care and experience in the practice of dentistry.
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For further information, please visit us online at http://www.dentalcrossing.com
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Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:
Contact Information:
| Contact Name: - |
Company Type: Employer |
| Company: DentalCrossing |
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| City: Pasadena |
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| State: California |
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| Zip: |
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Web Site: http://www.dentalcrossing.com
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