Oral Health Specialist

Oral Health Specialist

All Care Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options.

The Oral Health Specialist is responsible for supporting the administration, coordination, and oversight of oral health programs and benefits for Coordinated Care Organization (CCO) members in compliance with Oregon Health Plan (OHP) contractual requirements and applicable regulatory standards.

This position serves as a primary resource for oral health operations, collaborating with Dental Care Organizations (DCOs), providers, internal departments, and community partners to support program implementation, provider engagement, compliance monitoring, policy development, and quality improvement initiatives.

The Oral Health Specialist works closely with BMPS Leadership, Compliance Leadership, Medical Directors, Population Health Leadership, and interdisciplinary teams to improve access to high-quality oral health services and advance equitable health outcomes.

Essential Duties

Job Duties

• Act as a key resource for oral health operations, with a focus on compliance, benefit management, and provider relations.
• Serve as the primary liaison between oral health subcontractors and All Care Health, fostering effective communication and collaboration.
• Support All Care Health and its oral health subcontractors in maintaining compliance with contractual requirements, Oregon Administrative Rules (OARs), and Code of Federal Regulations (CFRs) for oral health benefits by leading regular monthly check- in meetings with each DCO. Also attending monthly All Care subcontractor meetings to present any findings or concerns.
• Assist in maintaining and updating oral health policies to ensure they remain relevant, accurate, and aligned with regulatory requirements.
• Provide operational support to the Medical Director for Oral Health and the Medical Director of Orthodontics, ensuring seamless program implementation.
• Represent All Care Health in local, state, and regional oral health meetings and committees as directed by organizational leadership.
• Support the development of new access points for oral health services to improve care delivery for All Care members.
• Monitor oral health provider contracts to ensure compliance with quality standards and oversee implementation of alternative payment models (APMs) for Dental Care Organizations (DCOs) and individual providers.
• Assists provider engagement team with the development of language and requirements for contracts and provider education.
• Assists grievance team when needed to investigate and document complaints related to oral health services, ensuring appropriate follow-up and resolution.
• Coordinate internal and external teams on population health initiatives, including care coordination for oral health issues as delegated.
• Provide excellent customer service by addressing provider and/or DCO concerns in a timely and effective manner.
• Maintains punctual, regular and predictable attendance.
• Works collaboratively in a team environment with a spirit of cooperation.
• Respectfully takes direction from leadership.
• Meets all required training including those listed in Relias Learning Module System (LMS).
• Performs other duties as assigned.

On Call Responsibilities

This position does not have any on call responsibilities.

Supervisory…