Remote Part-Time Dentist: Utilization & Review

Liberty Dental Plan; Tustin, Nevada (CA, IA); Hybrid; USD 101,942 - 112,963; Part time

Benefits offered by this job

Fully remote position

20 hours per week

Competitive hourly pay

401(k) employer match

EAP and wellness benefits

Paid holidays and vacation accrual

Hybrid/remote work options

Job summary

Liberty Dental Plan is seeking an experienced Staff Dentist to support Utilization Management and Utilization Review programs. This fully remote, part‑time role (20 hours/week) focuses on reviewing dental claims, prior authorizations, referrals, and treatment requests across commercial and government programs.

The ideal candidate has a DDS/DMD, NJ license, at least 6 years of practice, and strong knowledge of coding, medical necessity, and regulatory standards.

Qualifications

• DDS or DMD degree from an accredited dental school.
• Current, active New Jersey dental license in good standing.
• Minimum of six (6) years of experience as a practicing dentist.
• Ability to complete Liberty Dental Plan credentialing requirements.
• Knowledge of dental procedures, coding standards, and medical necessity criteria.
• Ability to review radiographs, treatment plans, and chart documentation.
• Excellent written and verbal communication skills.
• Ability to manage review volumes efficiently while maintaining quality.

Responsibilities

• 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 Medicaid programs.
• Support regulatory reporting and accreditation‑related activities.
• Stay current with ADA CDT coding updates, evidence‑based treatment guidelines, and state‑specific requirements.

Skills

Communication skills

Regulatory understanding

Clinical decision making

Education

DDS or DMD degree

New Jersey dental license

Job description

Liberty Dental Plan is seeking an experienced Staff Dentist to support Utilization Management and Utilization Review programs. This fully remote, part‑time role (20 hours/week) focuses on reviewing dental claims, prior authorizations, referrals, and treatment requests across commercial and government programs.

The ideal candidate has a DDS/DMD, NJ license, at least 6 years of practice, and strong knowledge of coding, medical necessity, and regulatory standards.