Staff Dentist (Nevada & New Jersey)

About the Role

At LIBERTY Dental Plan, our Staff Dentists play a critical role in shaping how quality dental care is delivered at scale. In this fully remote position, you'll use your clinical judgment to review claims and prior authorizations, helping ensure members receive the right care at the right time. Your work directly influences patient outcomes, supports providers, and strengthens the integrity of dental benefits across Commercial, Marketplace, Medicare Advantage, and Medicaid programs. This is more than a review role—it's an opportunity to collaborate with experienced clinical leaders, contribute to meaningful quality initiatives, and grow your impact within a mission-driven organization dedicated to improving oral health nationwide.

What You'll Do

Utilization Management & Clinical Review

• Review dental claims and prior authorization requests, applying coverage guidelines and benefit plan policies to ensure accurate determinations
• Interpret dental records, radiographs, and clinical documentation to assess medical necessity
• Meet established productivity and quality benchmarks for clinical reviews
• Document clear, concise clinical rationale aligned with regulatory and accreditation standards

Calibration & Clinical Consistency

• Participate in calibration sessions to ensure consistent application of clinical guidelines and policies
• Complete interrater reliability assessments and meet accuracy benchmarks
• Raise complex or unclear cases for peer discussion and resolution
• Incorporate feedback from audits and reviews to continuously improve accuracy

Provider Engagement & Peer Review

• Conduct peer-to-peer consultations with providers regarding clinical decisions and treatment alternatives
• Support grievance and appeal reviews with clinical insight
• Collaborate with dental specialists and internal teams on complex cases

Training, Collaboration & Compliance

• Participate in clinical trainings and team meetings
• Partner with Utilization Management, Claims, Dental Directors, and Grievances & Appeals teams
• Support regulatory reporting and maintain knowledge of applicable standards and guidelines
• Stay current on ADA coding updates and evidence-based clinical practices

A Day in the Life

In this role, your day is highly focused and structured around clinical review and collaboration:

• ~90% of your time reviewing prior authorizations and dental claims using internal systems (including AI-supported platforms)
• Interpreting clinical documentation and applying your judgment to ensure accurate, compliant determinations
• ~10% of your time participating in calibration sessions, identifying trends (including fraud, waste, and abuse), and supporting workflow improvements

You'll start your day by logging in, reviewing assigned cases, and managing your review queue while maintaining quality and turnaround expectations. You'll also engage with colleagues and providers as needed to support accurate and consistent outcomes.

What You'll Bring

Required Qualifications

• DDS or DMD from an accredited institution
• Active, unrestricted Nevada and New Jersey dental license in good standing (required)
• Minimum 6 years of experience as a practicing dentist

Key Skills & Expertise

• Strong clinical judgment and ability to evaluate dental necessity and treatment appropriateness
• Ability to interpret dental radiographs and clinical records
• Knowledge of managed care systems, reimbursement models, and regulatory requirements
• Strong written communication skills to document clear and defensible clinical decisions
• Ability to manage high-volume review work efficiently while maintaining accuracy
• Comfort working in a remote, structured environment during standard business hours
• Proficiency with computer systems and ability to learn new technology platforms, including AI-supported tools

Work Environment & Expectations

• Fully remote position
• Structured schedule aligned with core business hours (not a flexible-hours role)
• Highly collaborative environment with cross-functional teams
• Focus on productivity, accuracy, and quality outcomes

Compensation

Salary Range: $150,000 – $165,000 annually (Final Compensation Will Depend On Experience, Qualifications, And Licensure.)

Benefits

• 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