Join the CVS Health team and bring your passion for delivering exceptional healthcare to our members. As a Clinical Dental Quality Consultant, you will play a vital role in ensuring our members receive top-notch dental care. With 60+ years of experience, Aetna Dental is a leading provider of dental care to over nine million members, and we’re seeking a dedicated professional to join our team.
In this fully remote position, you will serve as a key partner to our Compliance and Medicare business segments, reporting to Aetna’s National Dental Director. Your expertise will be instrumental in driving quality management initiatives, providing clinical guidance, and fostering partnerships that enhance our members’ experience.
Key Responsibilities:
- Provide expert clinical input and analysis to support operational functions, strategic goals, and regulatory compliance
- Participate in committees and collaborate with cross-functional teams to drive quality management and partnership initiatives
- Conduct clinical reviews of complaints and grievances, developing resolutions that meet regulatory requirements
- Support the identification and investigation of potential dental fraud, waste, and abuse
Requirements:
- Valid state license to practice dental hygiene
- Minimum 10 years of dental hygiene clinical practice experience
- Demonstrated success in project management, leadership, analysis, and implementation
- Knowledge of dental conditions, treatment, coding, billing, and current trends in the dental profession
- Proficient in Microsoft Office applications
Preferred Qualifications:
- Understanding of value-based contracting options, clinical quality programs, and clinical integration
- Financial acumen, strong problem-solving, and analytical abilities
- Excellent written, verbal, and presentation communication skills
- Familiarity with state regulatory bodies and dental benefit products
What We Offer:
- Competitive pay range: $105,446.25 – $227,100.00
- Eligibility for CVS Health bonus, commission, or short-term incentive program
- Comprehensive benefits package, including medical, dental, and vision coverage
- 401(k) retirement savings plan, Employee Stock Purchase Plan, and term life insurance
- Well-being programs, education assistance, and paid time off
Apply now to join our team and make a meaningful impact on the lives of our members. For more information on our benefits and company culture, visit jobs.CVSHealth.com/benefits.
