Senior Staff Dentist
LIBERTY DENTAL PLAN CORPORATION•Tustin, CA
•$175,000 - $185,000•Remote
About The Position
LIBERTY Dental Plan is seeking a highly experienced and collaborative 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. You will play a key role in reviewing claims and prior authorizations, partnering with providers, and supporting care delivery across Commercial, Medicare Advantage, and Medicaid populations—particularly within California Medicaid (Medi-Cal) programs.
Requirements
- DDS or DMD degree
- Active, unrestricted California dental license required
- 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
- 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
Nice To Haves
- 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
Responsibilities
- 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
Benefits
- Competitive pay structure and savings options
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Senior
