Staff Dentist (Part-Time, Remote)

Liberty Dental Plan; Tustin (CA); Hybrid; USD 102,000 - 113,000; Part time

Benefits offered by this job

Remote work options

Job summary

Liberty Dental Plan is seeking a Staff Dentist (Part-Time, Remote) to review dental claims and requests with clinical precision. You will evaluate treatment plans, radiographs, and chart notes to determine coverage in alignment with benefit structures and regulatory standards.

The role requires a DDS/DMD, active license, and 6+ years of practice, including Medicaid/Medicare experience. You will participate in QA and collaborates across teams to ensure consistent determinations.

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 years of experience as a practicing dentist.
• Experience working with Medicaid and Medicare Advantage dental programs.
• Ability to manage high-volume clinical review queues with accuracy and timeliness.

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, guidelines, and medical necessity criteria.
• Document clinical rationale clearly in accordance with regulatory requirements.
• Collaborate with leadership to address complex clinical scenarios and interpret questions.

Skills

Clinical review

Regulatory compliance

Licensure

Medicaid/Medicare

Communication

Team collaboration

Dental coding knowledge

Education

DDS or DMD degree

Active dental license

Tools

Overjet

Job description

Job Details: Job Location: All States (Remote) - OK, Position Type: Part Time, Job Category: Dental, Help Shape Better Oral Health Outcomes at Liberty Dental Plan

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.

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 consultations.
• Experience supporting grievances, appeals, and secondary clinical reviews.
• Familiarity with clinical review platforms, claims adjudication systems, and AI-assisted review technology such as Overjet.
• Knowledge of NCQA and URAC utilization management standards.
• Experience training, mentoring, or calibrating clinical review teams.
• Project management or process improvement experience.

Knowledge, Skills & Abilities

• Understanding of commercial, Medicare, Medicaid, and managed care dental programs.
• Knowledge of reimbursement methodologies, utilization management principles, and regulatory requirements.
• Ability to clearly communicate and support evidence-based clinical determinations.
• Strong computer proficiency and the ability to quickly learn new technology platforms.
• Ability to work effectively in a collaborative, team-oriented environment.
• Commitment to maintaining all required licensure and continuing education requirements.

What Success Looks Like

• Consistently meets or exceeds productivity, quality, and turnaround-time benchmarks.
• Effectively manages high-volume claims and authorization review queues without sacrificing clinical accuracy.
• Produces clear, defensible clinical rationales that support sound coverage determinations.
• Collaborates effectively with providers, peers, and leadership to ensure consistent application of clinical guidelines and benefit policies.

Why Join Liberty Dental Plan?

• Make a meaningful impact on the oral health of diverse member populations.
• Apply your clinical expertise in a collaborative, mission-driven organization.
• Help drive quality, consistency, and innovation in dental utilization management.
• Work alongside experienced dental and healthcare professionals dedicated to improving access to care.
• Enjoy the flexibility of a fully remote position with a predictable 20 - 24 hour-per-week schedule and competitive hourly compensation.

What Liberty Offers

• 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.

Employment Information

• Job Location: All States (Remote)
• Employment Type: Part-Time, Non-Exempt
• Schedule: 20 - 24 hours per week
• Compensation: $74.00 - $82.00 per hour

Compensation

In the spirit of pay transparency, the base salary range for this position is $74.00 - $82.00 an hour, not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions.

Please note that the range listed represents the full base salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth.

Employee Eligibility and Diversity

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.

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.

Sponsorship and Relocation Specifications

No relocation assistance or sponsorship available at this time.

Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.