Oral Surgeon, Dental Consultant (Part time, Massachusetts)

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.

Job Description:

Location: We welcome applicants from MA

** This is a contract position with Sunlife. Part time, 4 hours/month **

The Opportunity: The Dental Consultant, MassHealth Board of Hearings is the assigned representative of decisions for coverage made by DentaQuest as the third-party administrator on behalf of the MassHealth Dental Program at the Massachusetts Board of Hearings.

• Work with the DentaQuest MassHealth team to attend remote and in person scheduled hearings for members who have appealed to the Massachusetts Board of Hearings. At this time, hearings are generally held remotely, however some may be held onsite at either in Quincy, Tewksbury, Taunton, or Springfield, Massachusetts.
• Prepare a thorough review of the prior authorization decision, state regulations and the office reference manual for each appealed case prior to hearing.
• Represent DentaQuest [and MassHealth] with respect to the decision determined in compliance with state regulations at each hearing.
• Work collaboratively with the MassHealth / DentaQuest dental consultant team supporting the Massachusetts Board of Hearings to ensure consistency in the application of the rules and regulations established by MassHealth for the plan regarding the decisions made for coverage.
• Document hearing interactions / decisions and communicate to the MassHealth DentaQuest team for tracking and appropriate action.
• Attend meetings with the MassHealth team at DentaQuest and complete online training as needed.
• Other duties as assigned

What you will bring with you: 

Preferred:

• A Massachusetts licensed dentist with a specialty in oral surgery and graduated from a Commission on Dental Accreditation approved program.
• 5-10 years experience in practice as a licensed dental provider
• Excellent oral and written communication skills.
• Efficient PC skills (E-mail, Word, Excel).
• Ability to work as a team member.
• Required to attend additional training as requested/deemed necessary.
• Ability to attend 1 hour hearings, approximately 1-2 times per month, with 3-4 weeks’ notice on date and time

Required:

• Massachusetts active dental license in good standing required.

PHYSICAL DEMANDS:

• Incumbent must be able to communicate effectively.
• Requires overall light physical effort (up to 25lbs.)
• Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer).
• Ability to travel or move about within and outside serviced facilities required.

Do you see yourself in this role even if you haven’t checked all the boxes above? We welcome all talented candidates and are committed to a culture that represents diversity in all forms. If you think you might thrive in this setting, we would love to hear from you. 

Not ready to apply yet but want to stay in touch? Join our talent community to stay connected until the time is right for you! 

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. 

We consider various factors in determining actual pay including your skills, qualifications, and experience.  In addition to salary, this position is eligible for incentive awards based on individual and business performance as well as a broad range of competitive benefits. 

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making