Junior Dental Advisor

ABOUT THE POSITION

An opportunity exists for a Junior Dental Advisor.

The position offers flexibility to be based at our Head Office in Century City (Cape Town), or in the Gauteng region. Remote and/or Hybrid work model arrangements are dependent on the region the incumbent will be based.

The primary purpose of this position will be to adjudicate escalated clinical cases and provide clinical support to key stakeholders. Previous work experience at a Dental Practice will be advantageous in fulfilling this role, as the candidate will need to apply clinical expertise within a managed healthcare framework.

OVERALL ROLE AND RESPONSIBILITY INCLUDE, BUT NOT LIMITED TO:

• Provide dental managed care recommendations related to product design, tariffs, and protocol management
• Offer clinical advisory services to the managed care team, ensuring compliance with relevant legislation, rules, and regulations
• Evaluate complex clinical cases and make evidence-based recommendations to support utilization management and cost-effective care
• Develop, review, and refine clinical protocols and guidelines to enhance care quality within the managed care framework
• Assess treatment plans for compliance with best practices, managed care principles, and financial sustainability
• Analyze claims data and treatment trends to identify patterns, cost-saving opportunities, and areas for improvement
• Provide technical support and training on managed care policies, dental benefits, and reimbursement models to internal teams and where necessary to external stakeholders
• Conduct peer reviews and audits to ensure provider adherence to clinical and regulatory standards
• Manage relationships with industry stakeholders, clients, and service providers
• Monitor and interpret industry trends and regulatory updates, advising on necessary adjustments to policies and protocols
• Draft reports, clinical articles, and presentations for clients, members, service providers, and medical aid schemes
• Participate in key meetings and provider engagement initiatives, including workshops, webinars, and feedback sessions
• Ensure service level agreements (SLAs) are met and regulatory requirements are adhered to across managed care operations
• Maintain accurate clinical documentation to support compliance, reporting, and strategic decision-making
• Advocate for evidence-based dentistry to align managed care policies with national and international standards

KEY COMPETENCIES

• Clinical Expertise: Knowledge of dental procedures, evidence-based dentistry and treatment evaluation
• Benefit rules and dental protocols: Basic managed care knowledge through liaison with dental benefit administrators is highly desirable
• Regulatory Compliance: Familiarity with healthcare regulations and clinical governance
• Communication: Excellent verbal, written and presentation skills for effective stakeholder engagement.
• Leadership and professionalism: Ethical decision making, training capabilities and organisational skills
• Teamwork: Ability to thrive in a high pressure, team orientated environment

QUALIFICATIONS & EXPERIENCE

• Bachelor's degree in Dentistry/Dental Surgery
• HPCSA registration is required
• Minimum 1 – 2 years' experience at a private Dental Practice (including locum work)
• Clinical coding (Dental, Procedure, ICD and PMB Coding)
• Relevant knowledge of the dental industry and applicable legislation
• Proficient in MS Office

ROLE REQUIREMENTS

• Valid Driver's license and own reliable transport
• Willing to travel nationally as and when required
• Reliable internet connectivity and backup power supply is a prerequisite for remote work capability
• Candidates must have a clear criminal record