Dental Care Management Analyst
Job Details
Experienced
LIBERTY Dental Plan of California - Irvine, CA
Full Time
None
Day
Description

The Dental Care Management Analyst is responsible for the day to day activities that support LIBERTY Dental Plan's Dental Care Management program and initiatives. The DCM Analyst needs to be familiar with dental terminology and procedures, experienced working in a fast-paced environment, and comfortable interacting with internal and external staff at various levels. Must function effectively and efficiently under pressure while remaining flexible and open to change. The role requires data mining and understanding of utilization patterns. 

 

Essential Duties:

  • Analyze utilization data, research, and identify potential patterns; this includes data mining, understanding benefit plans and provider networks within the assigned markets, and recommending appropriate next actions according to findings
  • Generate applicable claims reports as needed for Dental Directors to review offices with potential utilization issues  
  • Collaborate with Dental Directors or clinicians on recommended actions and follow through to ensure appropriate next steps are taken within the established timeframe
  • Demonstrate ability to use Excel to sort, summarize, and calculate totals as necessary to review data and understand results
  • Prepare and summarize DCM activities and present to committees, clients, management, and regulators as requested  
  • Oversee tracking, scheduling, and analysis of data related to DCM audits
  • Review documentation from other departments for regulatory and internal compliance and provide feedback to management
  • Prepare meeting minutes and maintain supporting documentation for DCM committee meetings in accordance with the company’s guidelines 
  • Research and respond to requests for information in connection with RFPs, regulatory inquiries, and special projects
  • Prepare reports by collecting and analyzing information, or by clearly communicating report parameters and objectives to internal subject matter experts
  • Work with IT on various projects as needed and perform user acceptance testing when necessary to implement system enhancements
Qualifications

Education and/or Experience:

  • Bachelor's Degree from a 4-year college or university and 3+ years of related experience; OR equivalent combination of education and experience
  • Dental experience is required

Specific Skills/Knowledge:

  • Knowledge of dental terminology and procedure codes.
  • Strong data analysis and data mining skills.
  • Intermediate to advanced skills in MS Word, Excel, and PowerPoint; advanced Excel skills preferred.
  • Ability to prioritize and successfully manage multiple projects and ad hoc requests.
  • Ability to define problems, collect relevant data, establish facts, and draw valid conclusions.
  • Highly analytical and detail-oriented with ability to demonstrate command of details and to articulate those details at a higher level.
  • Strong written, oral, and interpersonal communication skills with ability to effectively represent the company with all internal and external customers, providing the highest level of customer service.

Environment and/or Physical Factors:

Work is generally performed within an office environment, with standard office equipment available. Sedentary work involves extensive sitting, typing, close range vision most of the time.

 

 

Sponsorship and Relocation Specifications:

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.

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