Director, Dental Policy
Company: Delta Dental of California
Location: Rancho Cordova
Posted on: May 16, 2020
AT DELTA DENTAL WE:
PROMOTE ACCOUNTABILITY, INTEGRITY AND COLLABORATION: Our employees
are collaborative, self-aware, and ethical. It is our expectation
to do the right thing and follow through on commitments.
FOSTER PROFESSIONAL DEVELOPMENT: Our employees take ownership of
developing themselves and others through coaching, mentoring and
providing/being open to constructive feedback and identifying
VALUE CUSTOMERS AND CULTIVATE POSITIVE EXPERIENCES: Our employees
take time to build rapport with customers, while anticipating and
exceeding their needs to ensure positive outcomes.
If you think this sounds like you, let s chat. We would love to
tell you more!
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ABOUT DELTA DENTAL
Delta Dental covers more Americans than any other dental benefits
provider. As an employee you ll take part in our mission to become
the trusted health partner by collaborating with our communities
and employees to reimagine and deliver new possibilities in an
ever-changing environment. Our Enterprise Strategy focuses on
pillars of Growth and Diversification, supported by the platforms
of Culture and People, Process and Technology. Our employees take
pride working for a purpose-driven organization and live our values
of Trust, Service, Excellence and Innovation.
We are part of the Delta Dental Plans Association, a network of
companies that provides dental coverage to 74 million people in the
U.S. Delta Dental of California, Delta Dental of New York, Inc.,
Delta Dental of Pennsylvania and Delta Dental Insurance Company,
together with our affiliate companies, form one of the nation s
largest dental benefits delivery systems, covering 33 million
enrollees. All of our companies are members, or affiliates of
members, of the Delta Dental Plans Association, a network of 39
Delta Dental companies throughout the country.
Delta Dental provides equal employment opportunities (EEO) to all
employees and applicants for employment without regard to race,
color, religion, sex, national origin, age, disability or genetics.
In addition to federal law requirements, Delta Dental complies with
applicable state and local laws governing nondiscrimination in
employment in every location in which the company has facilities.
This policy applies to all terms and conditions of employment,
including recruiting, hiring, placement, promotion, termination,
layoff, recall, transfer, leaves of absence, compensation and
At Delta Dental, our strategy is only as strong as the people who
execute it! We are hiring individuals that are not just right for
today but also for our future. We have built a foundation of
high-trust by treating all people with dignity, making and keeping
commitments, and consistently striving to do the right thing. Our
leaders optimistically share future possibilities to inspire and
motivate others toward their full potential. We expect our
employees to find ways to embrace positive change, be curious and
challenge the status quo, and provide solutions to unmet problems.
Joining Delta Dental means joining a culture focused on fostering
development, building genuine connections, recognizing each other s
strengths and sharing in successes.
The Director of Dental Policy is responsible for establishing,
interpreting and coordinating dental processing policy in
accordance with regulations and contractual agreements between
Delta Dental and the State of California as well as overseeing the
activities of the dental professional. This position leads a team
of Dental Consultants and ensures timely processing of Treatment
Authorization Requests (TARS).
How you will make an impact:
* Oversees the dental policy functions to ensure work is completed
in a timely and accurate manner as defined in division goals.
* Promotes a constructive work environment.
* Directs staff, including: determining staffing needs, setting
goals, interviewing, selecting, coaching, and evaluating the
performance of all direct reports.
* Ensures continuous education of staff and works with department
and/or enterprise trainer to develop written training materials and
* Develops annual department and project budgets; identifies
variances and takes corrective action as appropriate.
* Develops processing policies that adhere to regulations and state
* Communicates policy decisions to department staff, working with
them to adhere to standard operating policies and procedures and to
* Oversees Dental Policy and related committees.
* Reviews and resolves complaints, grievances and appeals cases
that cannot be resolved by staff.
* Reviews cases of suspected fraud, abuse and poor quality of
* Makes determinations on corrective action, suspension, or
termination of provider agreements.
* Performs miscellaneous duties as assigned.
What we look for:
* Doctor of Dental Surgery or Doctor of Dental Medicine with a
current California dental license and California Dental Association
* A minimum of 8 years clinical dentistry and claims processing
and/or quality assessment experience.
* A minimum of 4 years supervisory experience.
* Extensive knowledge of health care industry and dental procedures
codes and nomenclature.
* Excellent organizational/time management and project management
skills and multi-tasking abilities.
* Strong analytical skills to identify and evaluate business
* Strong management skills to effectively manage department
* Knowledge of clinical dentistry with ability to evaluate quality
of treatment performed.
* Knowledge of Delta Dental products, policies, claims, eligibility
and underwriting guidelines.
Benefits and perks:
* 12 days starting vacation plus 12 holidays and your birthday
* Multiple medical insurance options: 100% paid or low cost
* 100% paid dental insurance
* 100% paid vision insurance
* Onsite gym and/or gym discount and fitness incentive
* Culture of learning: substantial tuition reimbursement to improve
* Career growth: we love promoting from within
* Strong commitment to work/life balance
* Technology allowance
* Social responsibility and volunteer opportunities
Keywords: Delta Dental of California, Rancho Cordova , Director, Dental Policy, Executive , Rancho Cordova, California
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