Dental Director (Nevada) Job in Las Vegas, Nevada US

Dental Director (Nevada)

Are you seeking a new challenge in your career? Perhaps you are a practicing dentist who wants to take your career in a new direction? LIBERTY Dental Plan has an exciting opportunity for a Dental Director to join our growing company. LIBERTY Dental Plan is a Dental Benefit Corporation headquartered in Irvine, CA. Celebrating 10 years of service, we are one of the nation's fastest growing dental plans with a robust and advanced infrastructure which includes one of the most comprehensive Quality Management and Improvement Programs in the nation. LIBERTY Dental Plan provides a very unique combination of accountability (service), availability (management involvement) and competitive pricing (affordability). We provide dental programs to employer groups, individuals, associations, Labor Unions, Taft Hartley Trust Funds, municipalities and government sponsored programs. The ideal candidate will have oversight responsibility of LIBERTY Dental Plan of Nevada's Quality Management and Improvement Programs. By collaborating with other corporate Dental Directors you will develop clinical guidelines and quality management improvement processes. You will perform clinical review of claims, pre-estimates and specialty care referrals, grievance and appeal reviews, on-site chart review for the Nevada DHMO network, and backup for review for the CA Dental Directors. You will also actively participate in the Utilization/Credentialing/Quality Management committees. Identify potentially unnecessary services and care delivery settings, and recommend alternatives if appropriate by analyzing clinical protocols. Examine clinical programs information to identify members for specific case management and/or disease management activities or interventions by utilizing established screening criteria. Use clinical expertise to manage the clinical model, providing dental interpretation and decisions as required. In addition to a base salary we offer excellent benefits including medical, dental, vision, disability, life insurance, a 401(k) company match, free parking, paid holidays, and paid time off.