Clinical Manager-Insurance
Posted on 3/27/2023

51-200 employees

Remote • Dorchester, Boston, MA, USA
Experience Level
Desired Skills
Mergers & Acquisitions (M&A)
Finance & Banking
  • DDS or DMD from a CODA accredited dental school
  • 8+ years of management/clinical experience in a clinical dental program
  • Active dental license with experience implementing dental policies in dental care
  • In-depth knowledge of dental technology, dental science, and workflow
  • Possess knowledge of and ability to apply management principles and techniques
  • Outstanding interpersonal and communication skills, both oral and written
  • Ability to work collaboratively across multiple departments internally, and with external payers/partners
  • Develop and maintain relationships with clinical leaders of payers and dental care organizations to assist them in implementing Overjet's artificial intelligence to transform utilization management and improve patient outcomes
  • Establish a scalable dental implementation process with payers. This includes clinical requirement analysis, clinical review implementation workflow, and post-implementation support for payers
  • Ensure that Overjet's dental services are delivered per contractual requirements and in compliance with best practices of clinical policy implementation
  • Assist payers' key contacts who manage the implementation of AI with clinical issues in claim adjudication
  • Provide assistance and regular feedback to Overjet's clinical operations team to improve performance and to enhance customer success
  • Develop repeatable and consistent clinical metrics for product delivery
  • Provide payers with clinical confidence, credibility, and capability to seamlessly implement AI in national payers' workflows
  • Influence, educate, train, and transform payer clinical teams, and external and internal business partners on AI implementation of clinical review
  • Act as a liaison between internal clinical, engineering, and machine learning teams in improving the clinical product by continually providing them with feedback from users
  • Work closely with talent acquisition to ensure the hiring, retention, and training of qualified staff to support the clinical delivery of products and services to payers
  • Provide oversight to the professional review system on clinical reviews, self-audits, and quality management assessment reviews