Description:
Manager, Quality Management
Wichita office, Full-time position
Hours: Monday - Friday 8:00 a.m. to 5:00 pm.
Education:
AA/AS in statistical analysis or a health-related field is the minimum level of education desired.
Experience:
- 4+ years of clinical experience (medical/dental office or direct patient care) required
- 3+ years of insurance or equivalent experience required
- 1-3 years of medical/dental Utilization Management (UM) experience preferred
Licenses and Certifications:
RDA or RDH is a plus
Position Responsibilities:
- Provide weekly reports on performance metrics to manager
- Maintain HIPAA standards and confidentiality of protected health information; and consistently demonstrate compliance with HIPAA regulations, professional conduct and ethical practice
- Develops and implements methods to modify or create analysis criteria to identify and/or quantify provider underutilization or overutilization of dental services
- Prepares reports and exhibits from the findings of provider analyses and develops recommendations or intervention strategies to correct or prevent abusive practices
- Researches, analyzes, evaluates and implements standards for monitoring the quality of care provided by provider
- Identifies the need for and develops studies to monitor and/or evaluate the quality of services delivered by providers
- Researches, analyzes, and responds to inquiries from members, providers, clients, and regulatory agency personnel to resolve program and policy issues
- Perform other duties as assigned
Skills and Qualifications:
- Microsoft Office Suite (especially Microsoft Excel and Microsoft Access)
- Advanced knowledge of utilization management policies and procedures
- Excellent people skills
- Skilled in conducting telephone outreach and education
- Ability to manage multiple tasks simultaneously
- Ability to work collaboratively and effectively with a diverse group
- Knowledge of dental terminology and dental procedures
- Ability to analyze utilization data
- Ability to write reports using dental terminology
- Ability to maintain confidentiality of information
- Ability to communicate effectively with others
- Ability to maintain favorable public relations
Delta Dental of Kansas employees enjoy outstanding benefits....including health, dental, vision insurance, long term disability insurance, life insurance, 401(k) plan, tuition reimbursement, paid time off, paid holidays, and fitness reimbursement.
We offer competitive wages with bonus potential, plus top notch benefits! Come join our team!
Delta Dental of Kansas is an Equal Opportunity Employer.
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