[Hiring] Pediatric Orthodontist Claims Review @MMC Group

Role Description

We are seeking experienced dental professionals to support a New Hampshire Medicaid program through clinical review, consultation, and authorization oversight services. These are flexible, fully remote opportunities for providers who want to leverage their clinical expertise in a non-chairside consulting capacity while maintaining work-life balance.

• 1 Orthodontist & 1 Pediatric General Dentist OR 1 provider qualified in both Orthodontics and Pediatric General Dentistry
• Immediate priority is for Orthodontist coverage during July and August.

In this role, providers will review clinical documentation submitted by participating providers and determine authorization and payment decisions based on established clinical criteria and Medicaid guidelines. Providers will serve as subject matter experts supporting quality and appropriate care delivery within the Medicaid program.

This is an excellent opportunity for licensed dental professionals seeking flexible supplemental income, reduced clinical burnout, and meaningful impact in public healthcare programs.

Key Responsibilities

• Review of dental clinical documentation and treatment requests
• Evaluate cases for medical necessity and authorization approval
• Approve or deny claims based on clinical guidelines and program criteria
• Provide clinical consultation and oversight support
• Utilize expertise related to the Handicapping Labio Lingual Deviation (HLD) Index
• Maintain accurate and timely documentation of reviews and determinations
• Participating in hearings or office visits if required

Qualifications

• Orthodontist Requirements
• DDS or DMD from an accredited institution
• Completion of accredited Orthodontics residency program
• Active Orthodontic licensure
• Experience with Medicaid or utilization review preferred
• Familiarity with HLD Index strongly preferred
• Pediatric General Dentist Requirements
• DDS or DMD from an accredited institution
• Pediatric dentistry experience required
• Active dental licensure
• Experience reviewing pediatric treatment plans preferred
• Medicaid experience is highly desirable
• Licensing Requirements
• Must hold an active New Hampshire dental license OR be willing to obtain one
• Providers may work remotely from anywhere in the United States
• Must be willing to travel onsite at least once every two months or as needed for hearings

Schedule & Work Environment

• Fully remote opportunity
• Flexible scheduling
• Approximately 50 hours per month
• Independent consulting-style environment
• Part-time engagement

Benefits

• Flexible remote work arrangement
• Competitive hourly compensation
• Supplemental income opportunity
• Reduced administrative and clinical burden
• Meaningful contribution to Medicaid patient care quality
• Long-term consulting potential