Dental Hygienist Clinical Reviewer

Job Summary

A company is looking for a Dental Hygienist Clinical Utilization Reviewer - Remote.

Key Responsibilities:

• Review first-level Prior Authorization (PA) requests related to handicapping malocclusions, general dentistry requests, and treatment plan evaluations
• Ensure compliance with turnaround time for all first-level reviews
• Develop and maintain good relationships with contracted providers and consistently review and report trends for program improvement

Required Qualifications:

• Dental Hygienist with at least three years of clinical experience
• Experience with tools related to handicapping malocclusions, general dentistry, and preventative care
• Preferred experience working with state Medicaid programs
• Unrestricted license in the state of Arkansas as a dental hygienist