Dental Consultant (Clinical Screening and Compliance Dentist)

Date: Apr 23, 2024

Location:

Roseville, CA, US, 95747-6645

Req ID: 18815

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Gainwell Technologies Dental Consultants apply clinical expertise to review, approve, and/or deny dental treatment authorization requests and claims in accordance with CA Department of Health Care Services (DHCS) Medi-Cal Dental policies.

Your role in our mission

• Collect, track, follow up and analyze referrals of potential fraud, abuse, and substandard quality of care.

• Review and analyze the delivery, billing, and utilization of services on a case-by-case basis, to detect unusual practices, billing anomalies and potential abuse by Medi-Cal providers and/or members.

• Determine whether clinical screening examinations should be conducted and/or whether additional patient records are required for review in cases of potential fraud, abuse and/or quality of care.

• Collaborate with the clinical screening department to coordinate screening appointments and train/calibrate clinical screening dentists within the Program.

• Create, edit and present results of clinical screening and patient records findings as a part of written reports and verbal presentations.

What we're looking for

• A minimum of ten (10) years of experience as a dentist.

• Must hold an active CA dental license, in good-standing and free of any suspensions or sanctions from Federal, State or local jurisdictions.

• Proficiency in creating, querying, and analyzing reports.

• Strong writing skills with the ability to convey data in a clear and actionable manner.

• Demonstrated expertise and knowledge of Medi-Cal Dental criteria and clinical screening preferred.

What you should expect in this role

This is a full-time permanent regular salaried (W-2) employee position.
Upward career advancement is possible and encouraged.
Health (medical, dental, vision) and paid time off benefits start on day 1 of employment.
Company match 401K and other benefits available within months of starting.
Computer and other company provided items.
Monday through Friday work schedule.
First year of service will be fully remote (work from home)
In order to effectively work as a fully remote or hybrid worker (work from home on Monday and Friday and in the office other days) with Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.
- To Test your internet download and upload speed:
  - Go to Google.
  - Search for Internet Speed Test or click here.
Video cameras must be used during all interviews, as well as during the initial week of orientation if hired.

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This position is intended for pipelining. We will accept applications on an ongoing basis.

The pay range for this position is $116,000 - $135,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.