Integrated Resources, Inc.
Position: Dental Utilization Specialist\rLocation: Role will be based out of Newark or Hopewell, however the position will be mobile and will require state travel\rDuration: 6 Months (Potential to Perm)\r\r \rJob Description:\rThis position is a Dental Utilization Auditor, responsible for reviewing, analyzing and monitoring the practice patterns of Dentist. This position determines whether treatment meets the appropriate standard of care and maintains cost effectiveness.-Audit patient records to evaluate practice patterns and interprets the treatment for appropriateness.\r\r Consults and educates the dentists on utilization and practice patterns.\r Suggests and helps develop corrective action plans.\r Identify, verify, prepare and present audit findings to the UM Committee.\r Monitor, track and report on utilization trends to support recommended alternate courses of treatment.\r Member of the UM Committee\r Perform other duties as assigned by management\r\r\r\r
Education/Experience:\r\r Prefer a Bachelor's degree from and accredited college or university will consider work experience in a related field.\r Requires a minimum of three (3) years- experience in a clinical setting.\r Prefers 1 year experience the health care delivery system/industry\r\rAdditional licensing, certifications, registrations:\r\r Must be licensed Dental Hygienist\r Requires a valid Driver License\r\rKnowledge:\r\r Requires knowledge of dental products, managed and traditional\r Prefers working knowledge of utilization review and quality management protocols.\r Requires knowledge of CDT 2013\r Prefers knowledge of health care contracts and benefit eligibility requirements\r\rSkills and Abilities:\r\r Requires excellent oral and written communication skills.\r Requires the ability to work in a high volume environment with moderate supervision.\r Requires the ability to apply an understanding of business fundamentals and administrative expense management of day to day decision making.\r\r\rTravel (If Applicable):\rStatewide travel required to conduct onsite audits at participating provider offices.
Integrated Resources, Inc.
Website : http://www.irionline.com/
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. With today’s growing demand for talented and well qualified professionals, it’s more important than ever to partner with a company that employs innovative measures to meet your demands. Our expert team of highly trained counselors work hand in hand with every client forming a partnership of understanding and commitment. Our clients know that they can rely on us for prompt response times and reliable staff to meet their workforce demands. Our employees know that they can trust our support for their career development and personal growth. IRI is proud to be JCAHO Certified by the Joint Commissions of Health, MBE Certified by the State of NJ and the National Minority Supplier Diversity Council (NMSDC) and SBE Certified by the State of NJ.