Job Summary
Homeland has partnered with a leading provider of employee benefits, specializing in dental health coverage for millions across the U.S. Our client is seeking a Bilingual Clinical Case Manger to join their team.
Our client is an ancillary insurance company dedicated to guiding members and communities toward wellness through innovative, tailored offerings delivered with a personal touch. They envision a future where individuals live more fully, communities thrive, and everyone has brighter prospects. They strive for excellence every day while remaining humble, helpful, and positive. Their high standards may not suit everyone, but for those who care deeply about improving lives, this is a place to flourish.
The Bilingual Dental Clinical Case Manager is responsible for overseeing the coordination, delivery, and quality of dental services within the company's and our provider network. This role includes managing member care, optimizing treatment plans, ensuring compliance with clinical guidelines, and collaborating closely with dental providers, staff, and members to enhance care outcomes. The Dental Clinical Case Manager plays a vital role in improving member satisfaction, managing clinical operations, and promoting best practices in dental care. This position involves direct interaction with members and providers to ensure the delivery of high-quality dental care.
Responsibilities
- Oversee and coordinate the delivery of dental care services, ensuring treatment plans align with clinical guidelines and member needs
- Collaborate with dental providers and staff to develop comprehensive care plans for members with complex dental conditions or ongoing treatment needs
- Monitor member progress and ensure appropriate follow-up care and referrals are provided to enhance treatment outcomes
- Serve as a point of contact for members, providing education on treatment options and addressing questions or concerns about dental care
- Coordinate care for members requiring multiple treatments or specialists, ensuring timely access to care and minimizing delays
- Promote preventive care and educate members on oral hygiene practices to reduce the incidence of dental diseases
- Monitor the quality of dental care services, ensuring adherence to best practices, clinical guidelines, and regulatory standards
- Identify areas for improvement in clinical care processes, member outcomes, and satisfaction; collaborate on quality improvement initiatives
- Collect and analyze data on clinical performance, member outcomes, and satisfaction metrics, providing feedback to the quality team
- Work closely with dental providers and staff to support clinical decision-making and maintain the highest standard of care
- Provide ongoing training and education to dental staff on clinical protocols, infection control, member communication, and care coordination
- Ensure compliance with state and federal regulations, dental board requirements, and accreditation standards
- Monitor adherence to clinical documentation standards and manage member records appropriately
- Serve as a liaison between dental providers, staff, and members to ensure clear and effective communication regarding treatment plans, follow-up care, and clinic operations
- Collaborate with other healthcare providers, including physicians and specialists, to coordinate interdisciplinary care for members with broader health needs
- Participate in meetings and interdisciplinary discussions to enhance member care coordination across departments
- Develop and implement strategies to improve member experience and satisfaction, ensuring care is member-centered, compassionate, and responsive to individual needs
- Collect and address member feedback, complaints, or grievances in a timely and constructive manner
- Implement initiatives to enhance the member experience, such as improving access to care, reducing wait times, and providing clear communication on treatment plans
Requirements
- Bachelor’s degree or equivalent education and work experience in a similar role
- 2+ years of experience in care management, case management, care coordination, or a similar position
- 2+ years of experience in managed care government programs, such as Medicaid and Medicare
- Strong understanding of dental clinical guidelines, infection control practices, and regulatory standards
- Excellent organizational, leadership, and communication skills, with the ability to manage clinical operations and coordinate care across teams
- Ability to accelerate impact and effectively collaborate across multiple teams to achieve common goals and objectives
- Strong written and verbal communication skills with attention to detail and emphasis on concise, objective, and relevant documentation
- Proficiency in healthcare management software, data analytics tools, and Microsoft Office Suite
Additional Information
A valid driver's license and the ability to use your own vehicle are required. You must be able to travel up to 50% to meet prospective clients, existing customers, and attend trade shows and other meetings as necessary. Travel requirements may vary throughout the year, ranging from short or overnight trips to extended stays in different regions for project or client implementation and customer guidance. Modes of transportation may include public options such as rail, bus, car, and/or plane. Travel and mileage reimbursement will be provided in accordance with the IRS annual mileage program and/or receipts submitted through the company expense report policy.
Benefits
Our client provides meaningful and challenging work that fosters innovation in a secure and compliant environment, alongside a competitive compensation package. Benefits include comprehensive medical, dental, vision, life, and disability coverage for employees and their dependents with no waiting period, a 401(k) plan with company match, tuition assistance, paid parental leave, and backup family care. Their collaborative workspaces encourage creativity and talent development, while flexible time off, dress code, and work location policies promote work-life balance. The company values inclusion and diversity through Employee Resource Groups and is dedicated to social responsibility, community outreach, educational partnerships, and sustainability efforts.
Summary
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EEO Notice
Homeland LLC is an Equal Opportunity Employer. Homeland LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state, and local laws. Homeland LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.