Dental Consultant, Independent Contractor

Remote

Who We Are

Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes.

What You’ll Do

The Dental Consultant supports Constellation’s payment integrity work, both directly and under contract with our partners. This position is responsible for conducting detailed reviews of clinical records to determine appropriateness of treatment, timelines and fact chronology, determination of reasonable and necessary treatment modality, causation, and medical necessity. This includes assessing consistency between diagnosis, procedures, and clinical documentation. The Dental Consultant works collaboratively with program staff to provide expert opinions on care provided to patients and develops formal, professionally written summaries of those opinions based on evidence and accepted practice standards as derived from a review of the supporting documentation.

We Expect You To:

• Utilize best practices to assess dental documentation to determine causation, appropriateness of treatment, and determine medical necessity.
• Review clinical documentation for reasonable and necessary treatment modalities including assessment of consistency between diagnosis, procedures, and other treatments.
• Document expert opinion of clinical findings, assessment of care, and utilization of practice standards in a professionally written, formal summary report.
• Respond to and/or attend hearings as required which may include some travel.

This position is contingent upon work assigned by the customer and works remotely on an as needed basis.

Our requirement for this role:

• Licensed Dentist (DDS or DMD) in good standing
• Minimum 3-5 years of experience in performing expert clinical review of treatment records including review of radiographs, procedure reports, treatment notes, and other records in support of causation
• Demonstrated ability to communicate complex clinical information to diverse audiences.
• Strong written, verbal, visual, and interpersonal communication skills.
• Experience developing formal, professionally written reports which may be used during litigation.
• Ability to manage multiple projects simultaneously and meet deadlines in a fast-paced environment.
• Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, Outlook, Teams, and SharePoint) for documentation, reporting, data management, and administrative functions.

Compensation & Contract Terms

• Hourly rate: From $125.00, per hour
• This engagement is contingent upon contract award, satisfactory performance and mutual agreement.
• The selected consultant will operate as an independent contractor and will not be considered an employee. The contractor will be responsible for their own taxes, insurance, benefits, and business expenses unless otherwise specified in a written agreement.
• The selected consultant agrees to maintain and provide current certificates of coverage for professional liability insurance ($1M /$1M) and cyber liability insurance ($1M /$1M)

Constellation Quality Health is committed to equal opportunity and nondiscrimination in contracting opportunities. We do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, gender identity, national origin, medical condition, disability, veteran status, or any other basis protected by law.