PCDH Coordinator

Oversees all aspects of Patient Centered Dental Home assignment, including system process updates, any provider requests or concerns related to member assignments or process, any member concerns, questions, or updates necessary, fulfilling reporting requirements, and communication to internal and external stakeholders. Ensures members are educated on dental wellness, including preventive care, comprehensive care, and acute care through collaboration with case managers and Managed Care Organization coordinators on overall outreach strategy.

• Supports key areas of the TennCare and Contractor’s Dental Home Strategy, monitoring utilization and prioritizing increased utilization of high-value preventative dental services, jointly designing the scope of responsibilities and high-value activities with TennCare.

• Implements the overall Dental Home Strategy, including supporting both member and provider outreach, coaching, and education.

• Collaborates with project management team on system updates, revisions, or additions to the Dental Home workflow in Roosevelt.

• Maintains and updates the Patient Centered Dental Home sections of the provider manual, as well as references within the member handbook.

• Monitors and analyzes reports regarding the Patient Centered Dental Home program. Proactively identifies opportunities and barriers to patient dental utilization.

• Ensures that members and their families receive preventive services from a trusted primary care dentist, which helps control oral diseases and reduces the need for restorative services.

• Facilitates communication between members, dental providers, Managed Care Organizations and other healthcare professionals to ensure continuity of care.

• Seeks input from others, listens effectively, and uses diplomacy, tact, and consensus to build relationships and gain trust, respect, and support with internal and external stakeholders.

• Develops, recommends, implements, and enforces policies, procedures, guidelines, and standards of operations for the Dental Home Strategy.

• Assist in periodic compliance efforts and ensure compliance with healthcare regulations and standards.

• Develops ad hoc reporting for Dental Home strategy independently, or in collaboration with internal reporting teams, for internal and external use.

• Directs tracking of provider terminations and reassigns members to another Dental Home, as necessary. Reassigns members upon request from TennCare, providers, MCOs, or DDA, as well as at member request through automated systematic processes, or manually, as necessary.