Dental Hygienist

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JOB DESCRIPTION FOR DENTAL HYGIENIST II, DENTAL HYGIENIST, OFFICE OF THE MEDICAL DIRECTOR, MEDICAID/CHIP SERVICES, TEXAS HEALTH AND HUMAN SERVICES COMMISSION

Position Number: 00069419

Class Code: 4490

Salary Group: B24

Position Title:

Dentist Hygienist II

Functional Title:

Dental Hygienist

Job Description:

The dental hygienist for the Medicaid and CHIP Services Department (MCS) serves as a dental clinician in the Office of the Medical Director (OMD). MCS is driven by its mission to deliver quality, cost-effective services to Texans. OMD provides clinical consultation and guidance to other areas within MCS, throughout the Agency, and to external stakeholder organizations. It works to provide a clinical vision for improving the health of Texans by aligning MCS programs with state public health priorities. OMD also leads the utilization review team of MCS which is charged with ensuring that individuals receive medically necessary, cost-effective services.

This position reports to the Dental Director for MCS. The work involved is advanced (senior-level) dental consultive work to include integrated knowledge of the Medicaid/CHIP programs with up-to-date dental practices and evidence-based clinical guidelines. This critical work helps to shape policies and the delivery of comprehensive healthcare, to include dental services, to children and adults served by HHSC. The position performs advanced administrative, consultative, and managerial work to include advising staff on unusual or difficult/clinical issues. Work also involves planning and coordination of dental programs and activities in close consultation with the Dental Director and other HHSC staff within MCS. This includes assisting in articulating a vision for the advancement of dental services for Medicaid and CHIP Programs.

Duties include providing dentistry-related training and the provision of technical assistance to HHSC staff. The dental hygienist provides clinical guidance and interpretation of HHSC policy through review of rules and standards. The position interfaces with a variety of stakeholders and stakeholder organizations to include providers, advocates, advisory committees, legislators, and other policymakers. This position interfaces with relevant staff from other state agencies (e.g. Department of State Health Services, HHS Office of the Inspector General), vendors, contractors (e.g. TMHP), and Dental Maintenance Organizations (DMOs).

This position works under limited supervision with considerable latitude for the use of initiative and independent judgement.

The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy.

Essential Job Functions:

45% Serves as a key dental clinical subject matter expert across Medicaid and CHIP programs. Provides clinical guidance and technical assistance for the development, updating, and improvement of dental benefit policy for both children and adults. Serves as a dental subject matter expert for HHSC dental education efforts. Provides professional review of proposed dental service plans as it relates to adult clients in waiver programs. Contributes to the review, notifications, and updating of the dental sections of the Texas Medicaid Provider and Procedures Manual (TMPPM) on a monthly basis. Provides technical assistance and consultation on dental managed care contracts, DMO operational reviews, and dental readiness activities. Provides clinical guidance with analysis of legislation, legislative implementation, and litigation, as needed. Collaborates across many HHSC departments related to fee schedules, claim adjudications, prior authorizations, dental quality measures and general oversight of dental managed care issues. Provides clinical guidance to the Provider Finance Department on reviews of dental fees.

20% Provides clinical guidance and technical assistance in the development of external-facing trainings on oral health/dental topics.

20% Analyzes data, identifies discrepancies in benefit policies, and makes recommendations to improve child and adult oral health and dental outcomes. Works with the Managed Care Contracts & Oversight (MCCO) team to identify, research, and resolve complaints and concerns involving Medicaid dental providers as well as clients.

10% Travels as needed. Attends key Medicaid/CHIP oral health/dental internal and external stakeholder meetings. Such activities may include meetings with the dental directors from DMOs, dental/oral health staff at other state agencies, as well as key stakeholder groups such as the Texas Dental Association and the Texas Academy of Pediatric Dentistry.

5% Conducts special projects or other duties as assigned in support of the Medicaid and CHIP Services Division.

Registrations, Licensure Requirements, or Certifications:

Candidate must be licensed as a Dental Hygienist by the state of Texas.

Knowledge, Skills, Abilities:

Knowledge of state and federal laws and regulations related to dental and oral health programs to include the Texas Health Steps program.

Knowledge of program planning, implementation, and evaluation.

Knowledge of local, state, and federal laws and regulations and of the principles of public administration and management.

Knowledge of the Medicaid Program and Children's Health Insurance Program to include Medicaid waiver programs.

Knowledge of and expertise in the clinical practice guidelines development process.

Ability to understand and effectively interpret agency and program rules, policies, and procedures.

Ability to lead a multi-disciplinary team.

Ability to perform policy and dental/oral health literature research.

Ability to write medical and program policy.

Ability to communicate effectively orally and in writing.

Ability to coordinate activities among public, private, and professional groups.

Ability to exercise judgment in evaluating situations and making decisions.

Skill in problem identification, analysis, and resolution.

Skill in policy development, implementation, and evaluation

Skill in process facilitation techniques, team-building, conflict resolution, and strategic planning.

Skill in the use of computer software, specifically Windows, Microsoft Outlook, Word, Excel, and Power Point.

Skill at establishing and maintaining productive working relationships both internally and externally.

Initial Screening Criteria:

Current license to practice dental Hygiene granted by the Texas State Board of Dental Examiners in good standing.

Graduation from an accredited dental hygiene school.

At least five years of experience as a licensed practicing hygienist.

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework.  Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.