[Hiring] Staff Dentist @LIBERTY DENTAL PLAN CORPORATION

Role Description

At Liberty Dental Plan, our mission is to improve oral health by delivering high-quality, accessible, and cost-effective dental benefits. We are seeking an experienced Staff Dentist to join our clinical team and play a critical role in supporting our Utilization Management (UM) and Utilization Review (UR) programs.

This fully remote opportunity offers a consistent 20-24 hour-per-week schedule, allowing experienced dentists to apply their clinical expertise in a collaborative managed care environment while helping improve access to high-quality oral healthcare. You will review dental claims, prior authorizations, referrals, and treatment requests across Commercial, Marketplace Exchange, Medicare Advantage, and Medicaid populations, helping ensure members receive appropriate, evidence-based care while supporting quality outcomes and regulatory compliance.

Qualifications

• DDS or DMD degree from an accredited dental school.
• Current, active, unrestricted dental license in good standing from any U.S. state or territory.
• Minimum of six (6) years of experience as a practicing dentist.
• Experience working with Medicaid and Medicare Advantage dental programs.
• Demonstrated ability to efficiently manage high-volume clinical review queues while maintaining exceptional accuracy, quality standards, and compliance with regulatory and internal turnaround time requirements.
• Ability to successfully complete Liberty Dental Plan credentialing and recredentialing requirements.
• Strong knowledge of dental procedures, clinical guidelines, coding standards, and medical necessity criteria.
• Ability to review and interpret dental radiographs, treatment plans, and chart documentation.
• Strong computer proficiency and the ability to quickly learn new technology platforms.
• Excellent written communication skills with the ability to develop clear and defensible clinical determinations.

Requirements

• Review dental claims, referrals, and prior authorization requests across multiple lines of business.
• Apply clinical expertise to evaluate treatment plans, radiographs, chart notes, and supporting documentation.
• Make coverage determinations based on benefit plans, clinical guidelines, medical necessity criteria, and applicable policies.
• Meet established productivity, quality, and turnaround-time standards.
• Document clinical rationale clearly and accurately in accordance with regulatory and accreditation requirements.
• Participate in calibration sessions to promote consistency and accuracy in clinical decision-making.
• Complete inter-rater reliability assessments and support ongoing quality improvement efforts.
• Collaborate with leadership and peers to address complex clinical scenarios and interpretation questions.
• Incorporate audit findings and feedback to continuously enhance determination accuracy and documentation quality.
• Conduct peer-to-peer consultations with treating providers regarding clinical determinations and treatment alternatives.
• Participate in grievance, appeal, and secondary review activities.
• Consult with dental specialists and subject matter experts as needed to support informed clinical decision-making.
• Maintain expertise in Liberty Dental Plan benefit structures and applicable Medicare & Medicaid programs.
• Support regulatory reporting and accreditation-related activities.
• Stay current with ADA CDT coding updates, evidence-based treatment guidelines, and state-specific requirements.
• Participate in required training programs, departmental meetings, and organizational initiatives.

Benefits

• Competitive pay structure and savings options to help you reach your financial goals.
• Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice through Financial Engines.
• Employee Assistance Program (EAP) to support mental health and well-being.
• Generous vacation and sick leave policies, with the ability to roll over unused time.
• Paid company holidays.
• Remote or hybrid work options available for various positions.

Company Description

Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture.

Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.