Senior Dentist

About the Role

LIBERTY Dental Plan is seeking a highly experienced Senior Staff Dentist to provide clinical leadership across our Utilization Management (UM) and Utilization Review (UR) programs. This role is ideal for a dentist with experience in the dental benefits (payer) environment who is passionate about improving care quality, ensuring compliance, and driving better health outcomes.

• Review dental claims, referrals, and prior authorization requests to ensure medical necessity and regulatory compliance
• Interpret dental records, radiographs, and benefit plans to make clinically sound coverage determinations
• Identify utilization trends, inappropriate services, and opportunities to improve care delivery
• Conduct retrospective reviews and influence provider behavior through engagement
• Perform secondary reviews, including grievances and appeals determinations

• Participate in Quality Improvement and Performance Management initiatives (PPM, SIU)
• Conduct focused chart audits to identify utilization and care delivery patterns
• Contribute to quality committees and regulatory reporting
• Provide clinical expertise in resolving provider and member grievances

• Conduct peer-to-peer consultations with network providers
• Promote provider education and engagement to improve documentation and care quality
• Collaborate with specialists and internal teams on complex cases

• Work closely with Analytics, Utilization Management, Claims, Provider Relations, and G&A teams
• Partner with leadership on clinical initiatives, training, and operational improvements
• Participate in state oral health initiatives and internal programs

A Day in the Life

• ~30% peer-to-peer provider calls
• ~30% clinical reviews (DCM and HCA work)
• ~25% appeals and case reviews
• ~15% supporting clinical leadership and special projects

• DDS or DMD degree
• Active, unrestricted California dental license
• Must be in good standing and eligible for credentialing
• Minimum 6 years of experience as a practicing dentist
• Minimum 2 years of experience in utilization management, claims review, or quality initiatives
• Strong clinical judgment and ability to interpret dental radiographs and patient records

• Experience in the dental benefits or payer environment
• Familiarity with California Medicaid (Medi-Cal) programs
• Ability to obtain and maintain multi‑state licensure (company‑supported)
• Arizona license preferred
• Experience mentoring or training clinical peers

• Knowledge of managed care, reimbursement systems, and regulatory compliance
• Expertise in dental coding, clinical guidelines, and medical necessity criteria
• Strong communication and interpersonal skills for provider engagement
• Analytical mindset with the ability to identify trends and drive improvements
• Proficiency in Microsoft Office and ability to learn new systems

We offer a competitive benefits package supporting employees and their dependents, including: competitive pay structure and savings options, 401(k) retirement benefits with employer match, Roth IRA options, medical insurance with low‑cost premiums, 100% employer‑paid dental coverage, vision insurance, basic life and AD&D insurance equal to one times base salary, flexible spending accounts, voluntary benefit programs, long‑term disability coverage, expansive wellness programs, employee assistance program, generous vacation and sick leave policies, paid company holidays, tuition reimbursement, and remote or hybrid work options.

Base salary range: $175,000 - $185,000 annually, not including fringe benefits or potential bonuses. Final salary will be determined by factors such as geographic location, skills, education, and experience.

We comply with all applicable laws and regulations on non‑discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship is available at this time.