Associate Dental Director
State of Tennessee
Government , Health Care
Position Description / Responsibilities
Associate Dental Director
Reports to: Chief Dental Officer, Division of TennCare
Working title: Associate Dental Director, Division of TennCare
State Classification: Dentist
Location: Nashville, TN
TennCare is Tennessee’s Medicaid program that provides health insurance coverage for 1.4 million low income children, pregnant women, disabled adults, and adult caretakers of children. TennCare currently covers one out of every five Tennesseans and 50% of all Tennessee births, with an annual budget of $11 billion. TennCare partners with its managed care organizations (MCOs) to provide high quality integrated physical, behavioral, and long term care to its member. It also contracts with a statewide dental benefits manager (DBM) to administer oral health benefits to children and adults with intellectual and developmental disabilities who are members of the employment choices first waiver population.
TennCare’s mission is to support a healthier Tennessee by improving lives through high-quality cost effective care. TennCare has been a leader in innovation through clinical care models and delivery system payment reform while promoting the delivery of high quality services within a sustainable budget. TennCare’s Medical Office sits at the forefront of this mission to support clinical quality and operations, federal and state policy, and strategic innovation for the agency. Dental is an integral program within the Medical Office that is responsible for oversight of the DBM by leading innovative strategies focused on oral disease prevention and control, as well as improving clinical quality and health outcomes.
Operationally, the Dental Program works closely with other TennCare divisions, stakeholders, and TennCare’s contracted health plans to achieve its mission. The Associate Dental Director will be instrumental to the success of the dental program reporting directly to the TennCare’s Dental Director.
Monitoring the quality of oral health services provided to members by the contracted Dental Benefits Manager (DBM).
o Assisting with review of the DBM’s Quality Monitoring Program (QMP) to ensure both quality and appropriateness of care.
o Serving as a liaison with the DBM administrative and professional staff.
o Assisting with oversight of dental contracts assuring compliance with federal and state guidelines.
o Assisting in the review of dental policies of the DBM.
o Working closely with the DBM to assure that members receive covered services as medically necessary.
o Assisting with the review of clinical cases involving dental appeals.
o Assisting in the review of compliance of DBM with provider credentialing and service authorization timelines.
o Assisting TennCare’s Dental Director with ensuring that the TennCare Dental Fee Schedule and Cover Kids Dental Fee Schedule are both updated annually to comply with revisions to Current Dental Terminology and that the DBM notifies participating dental providers timely.
Represent TennCare with providers and community stakeholders to support dental strategy and engagement
o Serving as a liaison to the dental provider community and representing TennCare on external committees.
o Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, by telephone, or email.
o Partner with TennCare Dental Director to identify areas of innovation and improvement with the DBM dental directors and partner state agencies (e.g. TN Department of Health, Department of Intellectual and Developmental Disabilities, Department of Children’s Services)
o Providing insight to processes designed to improve the oral health of beneficiaries by participating in dental committees including the TennCare Dental Advisory Committee.
Support Clinical Innovation for TennCare Dental Program
o Reviewing the latest dental techniques, equipment and materials with an emphasis on those biomaterials that prevent and control oral diseases.
o Working with the TennCare Dental Director to develop strategies and policies for utilization of proven public health modalities.
o Participating in the development of payment reform mechanisms that are value driven or outcome based.
o Maintaining dental licensure requirements including current CPR and continuing education (CEUs) as regulated by the Tennessee Board of Dentistry.
Provide dental guidance and operational support to TennCare internal teams in support of integrated patient care
o Assisting the TennCare Dental Director through interaction with other programs within the Medical Office such as pharmacy, quality oversight, provider services, and member services as needed.
o Assisting the dental director in analyzing proposed legislation including fiscal impact.
· Current Tennessee Dental License
· Experience as a participating Medicaid provider
· 5+ years’ experience in dental project management such as, experience as Chief Dental Officer (CDO) Medicaid, CDO dental insurance company, or Public Health Dental Director
· Proficiency in Microsoft Office software including Word, Excel, and PowerPoint
· Excellent interpersonal, oral, and written communication skills
· Strong organizational, time management, analytical skills
· Prior experience leading and managing teams and direct report
· Experience in health care delivery and administration or state/federal health agency and policies
· Experience in managed care
· Experience with population health or value-based payment reforms
· Formal public health specialty training such as Diplomate of the American Board of Dental Public Health or Master of Public Health (MPH)
Salary/Range: Compensation and benefits arrangements are competitive and will be commensurate with the selected candidate’s experience and responsibilities of this position.
Pursuant to the State of Tennessee’s Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State’s policy to provide an environment free of discrimination and harassment of an individual because of that person’s race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran’s status or any other category protected by state and/or federal civil rights laws.
Interested candidates should send resumes and a brief writing sample to firstname.lastname@example.org