The Central Jersey Medical Center is a Federally Qualified Health Center in the state of NJ. Our mission is to provide primary and preventative care to patients regardless of ability to pay, race, ethnicity, and cultural competence. CJMC has locations in the Middlesex and Essex County areas and provides services to our patients in specialties such as Pediatrics, Internal Medicine, OB/GYN, as well as Dental care. By joining and being a member of our team, you will be able to give great care to patients as well as work in a great environment.
Main responsibility is to administer the dental program and direct departmental activities in accordance with accepted national standards and administrative policies. The fundamental reason this classification exists is to ensure that CJMC receives reimbursement for services rendered according to FQHC regulations. The position requires the CJMC staff to have a working knowledge of insurance billing policies and procedural guidelines. Coordinates the organization and delivery of services to various mobile dental van clinic site visits. Performs varied clinical and administrative duties and ensures compliance with established policies and procedures.
Key Responsibilities
- Assure productivity on mobile unit by clear, timely communication of the numbers of eligible students and the numbers of anticipated visits for treatment on all patients to be complete.
- Direct recruitment and management of dental networks.
- Direct dental network operation.
- Provide public-facing activities and interactions that will support the credibility and the brand of the company.
- Network and interface with thought leaders in the continuing effort to improve oral health within the communities for which the firm operates.
- Support the maintenance and enhancement of continuing provider network quality standards, efficiencies, and provider profiles.
- Direct the credentialing of providers through standardized policies and procedures.
- Oversight of quality review and utilization management practices.
- Continuous development of quality assurance policy development and deployment.
- Provide policies and procedures for covered and non-covered services.
- Oversee site reviews and requisite quality auditing.
- Establish guidelines for reasonable standards of care.
- Liaison with organized dentistry (e.g. American Dental Association) and the dental communities within the geographic area for which the firm operates.
- Liaison with large employee group health plans and states upon request.
- Chief liaison with organized dentistry, employers, the media, and other important stakeholders.
- Tracking vital signs on a monthly, quarterly, and annual basis, to show trends, to recognize successful performance by staff members, and to uncover problem areas in the practice before they become serious.
- Communicate with all dental vendors to facilitate services and review all invoices.
- Oversees the dental lab process by maintaining an accurate log, patient case evaluation, and reconcile all invoices prior to AR processing.
- Perform other duties as assigned.
- Special projects as needed.
Directly supervises 20+ Dental Employees in the Dental Department including Registration, Dental Assistants, Billing, and Dentists. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
- DDS or DMD from a nationally accredited institution.
- A minimum of 10 years operating within an insurance environment providing dental director services.
- Experience developing and deploying network-related policies and procedures within a medium to large size insurance environment.
- Large group public speaking experience on clinical and/or policy issues.
- Ability to provide network leadership and clinical guidance.
- Experience with managing and overseeing utilization reviews and site visits.
- Ability to present to and interact at the Board of Directors and Executive management levels.
- Senior leadership experience within a midsize to large firm and maintaining an executive level presence with all stakeholders.
- Management experience.
- Working knowledge of CJMC policies and procedures.
- Able to work as a team player.
Computer Skills
To perform this job successfully, an individual should have knowledge of Dentrix software.
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