Vice President, Dental Director

Description

At Delta Dental of Iowa, improving lives starts with a smile. We are seeking a Vice President, Dental Director to help advance our mission by serving as the clinical leader responsible for guiding evidence-based dental policy, improving oral health outcomes, and strengthening relationships across the dental profession. This role offers the opportunity to influence healthcare innovation, support providers and communities throughout Iowa, and represent one of the state's most respected health organizations as a champion for accessible, high-quality oral healthcare.

• Identify emerging technologies and trends in the dental industry and provide analysis and recommendations to the organization.
• Review utilization data, risk assessment data, evidence-based dental outcomes and current dental practice to determine payment policy and make recommendations as appropriate.
• Provide direction in the determination of dental necessity and appropriateness of treatment regimens, clinical policy for benefit review procedures, professional review for team interpreting and applying clinical processing policies for claims, application of credentialing standards as may be appropriate, and participation in the claims Appeals Committee.
• Oversee quality assurance program, including the establishment of metrics to assess the quality of care, development of processes and protocols to improve the quality of care if necessary, and assessments to determine if quality has been improved.
• Provide guidance and technical expertise in Government administration and contracting.
• Provide leadership and expertise to internal and external stakeholders to increase applicability and adoption of risk-based dental benefits and disease management.
• Partner with Professional Relations team regarding network recruitment/management issues, credentialing and fraud/abuse matters. Build collaborative relationships and influence partners to achieve shared business and health outcomes.
• Willingness and ability to travel with Provider Relations and/or Sales as needed.
• Serve as spokesperson externally to the marketplace, stakeholders and the profession on the value of appropriate dental care and dental benefits.
• Identify, train and calibrate professional dental consultants that can effectively adjudicate dental claims in adherence to DDIA and DDPA policies.
• Act a key liaison to and advocate for company to key stakeholders(i.e. Iowa Dental Association, Iowa Dental Board, Iowa Department of Health & Human Services , University of Iowa College of Dentistry).
• Represent Delta Dental of Iowa (DDIA) in research studies and other academic relationships including presentations and project participation with the College of Dentistry
• Represent DDIA in science, research, and health policy at the national and state level as opportunities become available.
• Provide input and support to Sales and Marketing for product development and improvement/modification of dental products.
• Support DDPA, DDIA Foundation and Community Impact work as an oral health expert on various committees, coalitions and ad hoc task forces to ensure alignment with DDIA as well as representation as an oral health leader. Demonstrate community partnership, relationship-building, and advocacy skills to advance oral health initiatives.
• Lead Provider Appeals Committee.
• Perform other duties as assigned.