Dentist; Part-Time, Remote

Position: Staff Dentist (Part-Time, Remote)
Help Shape Better Oral Health Outcomes at Liberty Dental Plan 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.

About the Role The Staff Dentist (Part-Time) is responsible for performing timely, accurate, and clinically sound reviews of dental claims and service requests. Working closely with providers, dental leadership, and cross-functional teams, you will support consistent coverage determinations, quality improvement initiatives, and exceptional member experiences.

Employment Type:

Part-Time, Non-Exempt Work Arrangement:
Fully Remote

Schedule:

20 - 24 hours per week Compensation: $74.00 - $82.00 per hour

What You'll Do Utilization Management & Clinical Review 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.

Clinical Quality & Consistency 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.

Provider Engagement & Peer Collaboration 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.

Regulatory & Operational Support 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.

What You'll Bring

Required 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.

Preferred Qualifications Prior experience reviewing dental claims, prior authorizations, utilization management cases, or clinical determinations within a payer, managed care, dental benefits, or health plan environment.

Experience conducting peer-to-peer provider…