Dental Hygienist Consultant

🔥 13 hours ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $64.5k - $92.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Review Medicaid Dental prior authorizations based on medical necessity, eligibility, State policy guidelines, and accepted dental practices • Review member Dental Histories and occasionally adjudicate Dental prior authorizations • Review and evaluate prior authorization submissions using multiple computer systems • Seek additional information or clarification from requesting providers when appropriate • Complete prior authorization adjudication in the Medicaid Management Information System (MMIS) • Participate in monthly meetings with Gainwell leadership, operational staff, clinical peers, and State stakeholders • Provide assistance and education to providers regarding specific prior authorization submissions • Collaborate with the Dental team to ensure timely adjudication of Dental Prior Authorization requests • Review communications to providers and members regarding new or revised policies • Serve as a clinical subject matter expert or liaison for internal Gainwell entities • This is not a patient-facing position

🎯 Requirements

• Current Dental Hygiene license in the state of WI, or a license from another state and ability to obtain a WI license prior to the position start date • Extensive experience in the Dental field • Knowledge of CDC codes • Knowledge of ForwardHealth Policy requirements for related codes • Knowledge of and/or experience working with the Wisconsin Medicaid program or other state Medicaid programs • Excellent interpersonal, oral, and written communication skills • Ability to meet deadlines and manage priorities with minimal direct supervision • Experience working with various partners or team members toward shared goals • Ability to communicate effectively and interpret policies and procedures

🏖️ Benefits

• Flexible hours • Work-life balance • Continuous learning and career development • Flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies • Up to 10% travel as needed