Staff Dentist

Join Our Team as a Staff Dentist!

Job Summary
The Staff Dentist will be primarily responsible for the Utilization Management and Utilization Review Programs, ensuring timely oral health decision-making and adjudication of dental claims and prospective requests for dental services. This role spans all lines of business, including Commercial, Medicare Advantage, and Medicaid programs, to promote financial stability and quality of care. Additionally, the Staff Dentist will participate in LIBERTY’s state oral health programs and other clinical review activities.

Key Responsibilities

Utilization Management & Review

• Conduct clinical reviews of claims and pre-authorizations across all lines of business to ensure compliance with contractual and regulatory timeframes.
• Participate in clinical trainings, calibrations, and interrater reliability testing, meeting required benchmarks.
• Engage in Quality Management and Improvement activities, including provider site reviews, utilization analysis, and counseling calls.
• Conduct Peer-to-Peer calls to discuss utilization trends, quality issues, and claims submission patterns.
• Perform secondary reviews, including grievance and appeal evaluations.
• Identify unnecessary services in care delivery and detect potential quality issues in claims submissions.
• Examine dental charts for focused audits on aberrant utilization and care delivery patterns.
• Conduct occasional on-site chart reviews for state provider networks.

Compliance & Quality Improvement

• Attend meetings with supervisory and administrative staff to discuss department operations, clinical findings, and training needs.
• Apply clinical expertise to make appropriate dental interpretations and decisions.
• Develop and maintain subject matter expertise in LIBERTY’s dental benefit plans and applicable State Medicaid Programs.
• Support regulatory reporting requirements as needed.
• Participate in Quality Improvement and Provider Credentialing Committees, contributing to the resolution of member and provider grievances.
• Collect and analyze data from grievance and peer review committees on a quarterly basis.

Additional Responsibilities

• Participate in enrollee tele-dentistry visits to provide clinical assessments and recommendations.
• Consult periodically with board-certified dental specialists for complex cases.
• Perform other duties as assigned.

Qualifications

Education & Experience

• Required: DDS/DMD degree with an active, unrestricted license to practice dentistry in a U.S. state or territory (must pass credentialing).

• Experience:

• Minimum 2 years of experience in processing claims according to policy.
• Up to 4 years of experience as a practicing dentist preferred.

Skills & Knowledge

• Strong knowledge of oral health care cost management and utilization review.
• Familiarity with commercial and managed care delivery systems, reimbursement models, and quality improvement initiatives.
• Proficiency in clinical dentistry procedure codes and medical necessity adjudication guidelines.
• Ability to examine and interpret dental radiographs and chart records.
• Must meet LIBERTY Dental Plan’s credentialing and re-credentialing requirements.
• Compliance with all federal and state statutes and regulations.
• Exposure to project management, with the ability to create and implement plans successfully.
• Computer literacy, with the ability to adapt to new system applications.
• Ability to apply alternate benefits when appropriate and in line with plan guidelines.
• Strong team collaboration and leadership capabilities.
• Commitment to completing continuing education (CE) credits for maintaining dental licensure.
• Additional state licensures may be required to meet regulatory needs.

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, BurnAlong memberships, 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 $130,000 - $170,000, 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.