Senior Staff Dentist
About The Role
LIBERTY Dental Plan is seeking an experienced and clinically driven Senior Staff Dentist to join our Clinical Affairs team. In this leadership role, you will help ensure the delivery of high-quality, cost-effective dental care by providing clinical oversight of utilization management and claims review processes. This position offers the opportunity to influence care quality and provider engagement across Commercial, Medicare Advantage, and Medicaid programs while contributing to meaningful oral health initiatives. You’ll collaborate with cross-functional teams and serve as a mentor and clinical resource to support consistent, evidence-based decision-making across the organization.
What You’ll Do
Perform clinical reviews of dental claims, prior authorizations, and referrals to ensure timely, accurate, and compliant determinations
Interpret dental records, radiographs, and benefit structures to assess medical necessity and coverage decisions
Identify inappropriate utilization patterns and recommend improvements to align with best practices
Conduct retrospective utilization reviews and support provider behavior change initiatives
Complete appeal, grievance, and secondary review determinations
Quality, Compliance & Improvement
Participate in quality management and performance improvement programs, including audits and provider performance initiatives
Conduct chart reviews to identify trends in care delivery and utilization
Support grievance resolution and contribute to regulatory reporting and compliance activities
Provide clinical insight during committee reviews and quality improvement efforts
Provider Engagement & Peer Collaboration
Lead peer-to-peer consultations with providers to discuss clinical decisions, utilization trends, and quality concerns
Support provider education around compliance, documentation, and care standards
Partner with specialists and subject matter experts on complex clinical cases
Leadership & Organizational Impact
Mentor staff dentists and support clinical calibration efforts to ensure consistency across reviews
Provide guidance to utilization management and claims teams
Collaborate with Analytics, Claims, UM, and outreach teams to improve operational outcomes
Participate in state oral health initiatives and organizational programs
A Day in the Life
In this role, your day is a blend of clinical review, collaboration, and quality improvement work:
~75% reviewing dental claims and utilization requests to ensure accuracy, compliance, and appropriate care decisions
~10% supporting quality initiatives, including investigating clinical trends and addressing care concerns
~5% handling expedited reviews with quick turnaround times to support members and providers
~5% participating in care management or interdisciplinary coordination efforts
~5% engaging in team collaboration, provider discussions, and other organizational priorities
You’ll regularly partner with teams across Analytics, Utilization Management, Claims, and Provider Outreach, while also connecting directly with network dentists through peer-to-peer consultations.
What You’ll Bring
Required Qualifications: DDS or DMD from an accredited institution, Active, unrestricted New Jersey dental license in good standing (required), Ability to obtain additional state licenses as needed (company-supported), Minimum 6 years of experience as a practicing dentist, At least 2 years of experience in utilization management, claims review, or quality improvement initiatives
Preferred Qualifications: Experience in the dental benefits or managed care industry, Experience mentoring or training peers, Multi-state licensure, Familiarity with Medicaid programs
Key Skills & Expertise
Strong clinical judgment and knowledge of dental procedures, coding, and adjudication guidelines
Ability to interpret radiographs and dental records
Knowledge of managed care systems, reimbursement models, and regulatory requirements
Experience identifying fraud, waste, and abuse trends
Strong collaboration, communication, and provider engagement skills
Proficiency with Microsoft Office and ability to learn new systems quickly
Compensation
Salary Range: $175,000 – $185,000 annually (Final Compensation Will Depend On Experience, Qualifications, And Licensure.)
Why Join LIBERTY Dental Plan?
At LIBERTY, you’ll be part of a mission-driven organization dedicated to improving oral health outcomes through quality, innovation, and collaboration. This role allows you to leverage your clinical expertise beyond traditional practice—impacting care delivery at scale while working alongside a passionate and supportive team.
Qualifications
Location: 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.
What Liberty Offers
Competitive and attractive benefit packages for employees, including:
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
Affordable medical insurance, with low-cost premiums for employee-only coverage
Liberty subsidizes the cost for eligible dependents enrolled in the plan
100% employer-paid dental coverage for employees and eligible dependents
Vision insurance with low-cost premiums for employee-only coverage and dependents
Company-paid basic life and AD&D insurance, equal to one times your base salary, with options to purchase additional supplemental coverage
Flexible Spending Accounts for healthcare and dependent care expenses
Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance
Long-term disability coverage
Expansive wellness programs, including company-wide wellness challenges, and gym discounts
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
10 paid company holidays
Tuition reimbursement for eligible educational expenses
Remote or hybrid work options available for various positions
Compensation
In the spirit of pay transparency, the base salary range for this position is $175,000 - $185,000 annually, 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.
Sponsorship and Relocation Specifications
Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship available at this time.