Become a part of our caring community and help us put health first
 

The Dental Director is responsible for providing clinical oversight to promote the oral health of the member population that Humana serves in Texas and other states. This is accomplished by analysis and adjudication of claims, appeals, and potential quality of care issues.

The Dental Director - Texas assists in the design, development, and implementation of appropriate policies, protocols, and procedures which are in compliance with the most current accepted professional standards.

o    Provides dental interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards.
o    Review dental claims consistent with current ADA CDT terminology and current professional standards
o    Review and resolve provider and member grievances and appeals
o    Provide and advance the clinical vision for the future of oral health by embracing technology, innovative diagnostic and preventive methods, data science, and medical/dental integration
o    Participate in the development of policies and criteria for claim review
o    Provide guidance around dental product design and development
o    Provide clinical input and interpretation to all Humana departments
o    Provide quality of care reviews, as needed
o    Work with Specialty Quality Manager on annual quality work plan
o    Chair quarterly Specialty Quality Improvement Committee
o    Sit as voting member on Corporate Quality Improvement Committee

MUST HAVE ACTIVE/CLEAR TEXAS LICENSE

Use your skills to make an impact
 

Required Qualifications

• o    DDS or DMD degree from an accredited dental school
  o    Minimum of 5 years of dental practice experience
  o    Current and unrestricted dental license from Texas
  o    Currently reside in the State of Texas
  o    Excellent written and verbal communication skills
  o    Strong organizational skills and multi-tasking abilities
  o    Detail oriented with analytic and problem-solving abilities

Preferred Qualifications
o    Knowledge and experience in dental benefits industry issues preferred
o    Knowledge and experience in Medicare and Medicaid dental programs

preferred

 
Additional Information
o    The Dental Director conducts clinical reviews of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews and/or condition committees.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$203,400 - $279,800 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.