[Hiring] Utilization Management Clinical Dental Lead @Avesis

Role Description

The Utilization Management Dental Clinical Team Lead is responsible for guiding a group of dental processors to achieve specific goals and objectives. Key responsibilities include:

• Ensuring effective communication within the team
• Monitoring performance and providing feedback
• Supporting professional development to enhance team productivity
• Resolving conflicts and fostering a positive work environment
• Coordinating with other departments for alignment and successful project completion

The UM (Utilization Management) Department supports clients and the company by utilizing clinical criteria to approve or deny services based on authorization. The UM Clinical Processor Lead ensures that healthcare services provided to members are appropriate, efficient, and effective.

As the Utilization Management Clinical Team Lead, you will:

• Assist with questions regarding dental clinical reviews
• Complete denial letter mapping requests for various client-based letters
• Perform monthly audits to ensure compliance and quality
• Conduct one-on-one coaching sessions with team members
• Assist with the upkeep of internal department documents
• Review questions and concerns from other departments
• Process prior authorization requests when necessary

Qualifications

• High School Diploma/GED
• Leadership experience required
• Proficiency with Microsoft Office and other Windows-based applications
• Strong reading, writing, and professional communication skills
• Ability to manage multiple tasks and prioritize work
• Analytical thinking and independent decision-making
• Adaptability to handle multiple and changing priorities
• Ability to maintain positive working relationships
• Effective time management and organizational skills
• Dental Assistant certificate or 2 years of chair side assisting
• Access to reliable internet connection (25 MBPS upload/50 MBPS download speed) and an appropriate workspace

Requirements

• Self-Motivation & Organization: Must be self-motivated and highly organized with the ability to work autonomously without direct supervision
• Flexible Hours: Work hours will be determined by your manager and may vary based on location, department needs, and workflow. Mandatory overtime may be required during peak seasons
• Deadline Adherence: Expected to meet established deadlines and deliver high-quality work consistently
• Virtual Collaboration: Use virtual platforms like Teams and Microsoft Outlook for collaboration
• Confidentiality: Maintain strict confidentiality of information related to Avēsis and its customers

Benefits

• Meaningful and challenging work opportunities
• Competitive compensation package
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period
• Life and disability insurance
• A great 401(k) with company match
• Tuition assistance, paid parental leave and backup family care
• Dynamic, modern work environments that promote collaboration and creativity
• Flexible time off