About the Role

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.

What You’ll Do

Clinical Review & Utilization Management

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

Quality & Compliance

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

Provider Engagement & Collaboration

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

Cross-Functional Partnership

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

A Day in the Life

~30% peer-to-peer provider calls
~30% clinical reviews (DCM and HCA work)
~25% appeals and case reviews
~15% supporting clinical leadership and special projects

What You’ll Bring

Required Qualifications

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

Preferred Qualifications

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

Key Skills

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

Why Join LIBERTY Dental Plan

Make a meaningful impact on oral health outcomes across diverse populations
Work remotely while collaborating with a mission-driven, cross-functional team
Help shape clinical quality, compliance, and best practices in the dental payer space
Engage directly with providers and influence care delivery at scale
Receive support for additional state licensure and professional development

Interview Process

Initial recruiter screening
45-minute interview with Hiring Manager
Final selection following candidate review

Apply Today

If you’re a clinically experienced dentist with strong judgment and payer experience—and you want to influence care at scale—we encourage you to apply and join LIBERTY Dental Plan.

Location

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.

What Liberty Offers

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That’s why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity.

Our first-class benefits package supports employees and their dependents with:

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.

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.

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

Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.

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