It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
Your role in our mission
- Review claims, Treatment Authorization Requests (TARs), and related documentation for California Medi-Cal members to support adjudication decisions, ensuring compliance with Medi-Cal Dental policies and procedures.
- Collaborate within a team of dental consultants to manage a shared workload of claims requiring the professional expertise of an experienced dentist. These claims are referred by other members of the Claims Processing team, making strong communication and collaboration skills essential to maintaining operational continuity.
- Assist with the training and onboarding of new dental consultants by providing guidance, mentorship, job shadowing opportunities, and coaching, as needed.
- Provide support to fellow dental consultants by reviewing complex cases and offering second opinions, including collaboration on cases involving special-needs populations served by the Medi-Cal Dental Program.
- Support other departments, as requested, including: (a) Claims Processing and Operations, (b) Provider and Member Services, (c) Grievances and Appeals, (d) Human Resources, Onboarding, and Interviews, (e) Quality Management, (f) Peer Review, and (g) referrals to and reviews of findings and adjudication related to Clinical Screening Dentist evaluations.
What we're looking for
- Minimum of ten 10 years of hands-on clinical experience practicing dentistry in a general dentistry setting or a recognized dental specialty.
- Active (non-expired) license to practice dentistry in California, in good standing and free of any suspensions, restrictions, or sanctions imposed by federal, state, or local regulatory authorities.
- Minimum of 2 years of experience working within an organization that provides Medi-Cal Dental services. Prior experience with adjudication and claims processing for the California Medi-Cal Dental Program is preferred but not required.
- Demonstrated expertise and in-depth knowledge of Medi-Cal Dental criteria, policies, and program requirements.
What you should expect in this role
- California residency required.
- Full-time, exempt salaried position (40 hours per week).
- Remote position with occasional onsite presence required at our Roseville, CA office, based on business needs.
- Employee must maintain Gainwell Technologies as their sole full-time employer.
The pay range for this position is $121,700.00 - $173,800.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
