Dental Hygienist Reviewer

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 company’s mission, actively engage in problem-solving, and take ownership of your work daily. 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 seeks a Dental Hygienist Reviewer to join our growing team.

Job Summary:

The Dental Hygienist Reviewer is responsible for the timely decision-making and adjudication of dental prior authorization requests. Prior authorization and post-payment reviews leverage patient care and treatment planning experience to support the healthcare business process services team. Our client may also request evaluations of dental health policy and preventative treatment plans. The Dental Hygienist Reviewer will complete their work with limited supervision.

*Position is remote within the State of Arkansas.

Job Responsibilities:

• Review first-level Prior Authorization (PA) requests related to handicapping malocclusions, general dentistry requests, and treatment plan evaluations

• Refer to second level peer reviewers when appropriate
• Ensure compliance with a turnaround time for all first-level reviews
• Develop and maintain good relationships with consumers
• Consistently review and report trends, and opportunities for program improvement
• Follow and adhere to policies and procedures internally per Oral Health Assessment (OHA) guidelines and Office of Oral Health (OARs) – Arkansas Department of Health
• Timely documentation that meets all best practice guidelines
• Collaboration with internal and external stakeholders
• Communication activities include telephone interactions, caregiver interactions, rounds, interdisciplinary team meetings, and other evidence-based practices
• Ensuring quality-driven outcomes through best practice and motivational interviewing
• Develops and maintains subject matter expertise in the dental benefit plan and applicable State Medicaid Program
• Perform other tasks as assigned or necessary

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.

Requirements

Required Qualifications/Experience:

• Unrestricted license in the state of Arkansas as a dental hygienist
• Dental Hygienist with 3+ years of clinical experience
• Experience with tools related to handicapping malocclusions, general dentistry, and preventative care
• Knowledgeable about current dental terminology, practices, materials, and generally accepted standards
• Expertise in clinical dentistry procedure codes and understand commonly accepted clinical and adjudication guidelines regarding the medical necessity of proposed dental procedures
• Ability to examine and read dental radiographs and chart records

Preferred Qualifications/Experience: 

• Experience working with state Medicaid programs
• Experience with Utilization Management

Why us? 

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.  

Compensation

The pay range for this position is $24.37-36.00.

“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”