Dental Services and Clinical Policy Manager (Remote in California)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

About the role

The Dental Services and Clinical Policy Manager is responsible for defining, managing, analyzing and improving dental consultant support related to Medi-Cal Dental clinical dental services and clinical policy, ensuring they meet agreed-upon standards and expectations. Oversees daily business operations, optimizing workflows, managing resources, recommending IT system updates, and ensuring productivity aligns with company goals. This position requires collaboration with various stakeholders to ensure Service Level Agreements (SLAs) and Key Performance Indicators (KPIs) are met, leading personnel and taking corrective action when necessary. This position will be based in Roseville, CA and requires working remotely within the state of California daily.

Responsibilities

• Manage a team of dental consultants supporting Medi-Cal Dental complaints and grievances, Conlan, First Level Appeals, outreach, provider training and State Hearing day-to-day activities to ensure operations run smoothly and efficiently.
• Analyze trends, develop and present data-driven improvement proposals, and implement strategies to improve policy, workflows, IT applications, productivity, quality standards and member utilization of dental services.
• Serve as a point of escalation, including the point of contact for the client, to support resolution of member and provider issues related to dental policies and access to dental services.
• Supervise, hire, train, and mentor employees to meet performance expectations and company goals.
• Partner with cross-functional teams to pursue project development and Go Live deployment.
• Handle special projects as assigned.
• Contribute to long-term planning and align daily operations with strategic objectives.
• Ensure clinical related operations adhere to relevant laws, regulations, and industry standards.
• Other duties as assigned.

Requirements

• DDS or DMD dental degree with a current, in good-standing, non-expired dental license from the State of California.
• Must be able to work remotely within California and maintain physical California residence.
• A minimum of five years of management / leadership experience with progressive increase in responsibilities.
• Solid understanding of Excel, data analytics and PowerPoint.
• Ability to demonstrate intelligence needed to assess workflows, processes and SLA requirements.
• Excellent verbal, written and presentation communications skills.
• Strong people management skills.

Benefits

• Health (medical, dental, vision) benefits start on day 1 of employment.
• Company match 401K and other benefits available within months of starting.
• Flexible vacation policy after ninety (90) calendar days of employment (any exception requires manager approval prior to employee's start date).
• Company provided computer for work use.
• Educational assistance.
• Leadership and technical development academies to help build your skills and capabilities.

Pay

The pay range for this position is $121,900.00 - $174,100.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Schedule

• Full-time permanent regular salaried (W-2) employee position.
• Monday through Friday work schedule (40 hours per week).
• Some travel may be required for training, seminars or other provider support events, less than 25%.
• Broadband Internet connections should have a minimum speed of 24MBS download and 8 MBS upload (greater speeds will provide better performance; Gainwell does not reimburse for internet connections).
• Video cameras must be used during all interviews, as well as during the initial week of orientation if hired. The use of AI during interviews is prohibited.