Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Summary
The Dental Services and Clinical Policy Manager is responsible for defining, managing, analyzing and improving dental consultant support related to Medi-Cal Dental clinical dental services and clinical policy, ensuring they meet agreed-upon standards and expectations. Oversees daily business operations, optimizing workflows, managing resources, recommending IT system updates, and ensuring productivity aligns with company goals. This position requires collaboration with various stakeholders to ensure Service Level Agreements (SLAs) and Key Performance Indicators (KPIs) are met, leading personnel and taking corrective action when necessary. This position will be based in Roseville, CA and requires working remotely within the state of California daily.
Your role in our mission
- Manage a team of dental consultants supporting Medi-Cal Dental complaints and grievances, Conlan, First Level Appeals, outreach, provider training and State Hearing day-to-day activities to ensure operations run smoothly and efficiently
- Analyze trends, develop and present data-driven improvement proposals, and implement strategies to improve policy, workflows, IT applications, productivity, quality standards and member utilization of dental services.
- Serve as a point of escalation, including the point of contact for the client, to support resolution of member and provider issues related to dental policies and access to dental services
- Supervise, hire, train, and mentor employees to meet performance expectations and company goals.
- Partner with cross-functional teams to pursue project development and Go Live deployment. Handle special projects as assigned.
- Contribute to long-term planning and align daily operations with strategic objectives.
- Ensure clinical related operations adhere to relevant laws, regulations, and industry standards.
- Other duties as assigned.
What we're looking for
- DDS or DMD dental degree with a current, in good-standing, non-expired dental license from the State of California.
- Must be able to work remotely within California and maintain physical California residence.
- A minimum of five 5 years of management / leadership experience with progressive increase in responsibilities.
- Solid understanding of Excel, data analytics and Powerpoint. Ability to demonstrate intelligence needed to assess workflows, processes and SLA requirements.
- Excellent verbal, written and presentation communications skills. Strong people management skills.
What you should expect in this role
- This is a full-time permanent regular salaried (W-2) employee position.
- Monday through Friday work schedule (40 hours per week).
- Some travel may be required for training, seminars or other Provider support events, less than 25%.
- Candidates must live in California.
- Health (medical, dental, vision) benefits start on day 1 of employment.
- Company match 401K and other benefits available within months of starting.
- New employees are eligible to take advantage of flexible vacation policy after ninety (90) calendar days of employment. Any exception requires manager approval prior to employee's Gainwell start date.
- Company provided computer for work use.
- For all hybrid and remote positions employees' Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance. Gainwell does not reimburse for internet connections.
- Video cameras must be used during all interviews, as well as during the initial week of orientation if hired.
- The use of AI during interviews is prohibited.
- This position will accept applications until August 10, 2026.
#LI-NB1
#LI-AC1
#LI-REMOTE
The pay range for this position is $121,900.00 - $174,100.00 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.
