LIBERTY Dental Plan is committed 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.
Staff Dentist
Location
United States
Posted
4 days ago
Salary
$150K - $165K / year
Seniority
Lead
No structured requirement data.
Job Description
Staff Dentist
LIBERTY DENTAL PLAN CORPORATION
Role Description Liberty Dental Plan is looking for a Nevada and New Jersey Licensed Staff Dentist to join our growing team! Unrestricted license or certification to practice dentistry in the State of Nevada & New Jersey. Ready to take your clinical expertise beyond the traditional practice setting? 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 - ~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. 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. - Experience with claims review, utilization management, or quality initiatives preferred. Requirements - 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.
Related Guides
Related Categories
Related Job Pages
More General Jobs
• Support students with special needs and additional assistance • Work closely with special education teachers, certified teachers, and school administrators • Implement instruction and support that meets students’ IEP needs • Assist teachers in delivering instruction using differentiated methods • Co-teach and collaborate with staff on modifications, accommodations, and interventions • Coordinate special education requirements with the Special Education Teacher • Track student progress and motivate students using incentives • Communicate with students, parents, teachers, and administration regarding student performance • Participate in meetings regarding special education students • Assist with pre- and post-school duties and school committee work • Promote a positive school environment by holding students accountable for rules
Payment Specialist
InnovaccerTwo years in a row: Innovaccer Awarded Best in KLAS Data & Analytics Platforms Category.
• Report to the Director, Clinical Transformation and work closely with the Payer Account Management and Accounting teams to ensure accurate, timely invoicing and payment distribution across PQS Enhanced Services programs. • Responsible for end-to-end payment operations—from invoice review and revenue tracking to disbursement coordination with PSAOs, chain pharmacies, and independent pharmacy organizations. • Collaborate with Payer Account Managers to review monthly invoices for Enhanced Services programs for accuracy. • Collaborate with Payer Account Managers to review invoicing monthly, quarterly and bi-annually. • Send finalized pharmacy and PQS invoice details to the accounting department for each payer on a monthly basis. • Work with the payer team to ensure new program invoices are generated as programs go live. • Coordinate on Payment process with Finance and Accounting teams including verification of independent pharmacy affiliations, sending revised payment details for disbursement, and collecting W-9 and EFT information from organizations. • Follow up with accounting and payer account managers on in-progress and delayed invoice payments. • Track PQS revenue for Enhanced Services payments and track payments by payee to support timely and accurate disbursement to pharmacies. • Answer all payment-related tickets and inquiries from organizations and pharmacies. • Work collaboratively with all PQS staff and its parent companies to ensure that PQS’ mission and plans are carried out successfully.
Technical Care Specialist II – Business
Cable ONECable One is now Sparklight, visit us at https://lnkd.in/gYiGXS3
• Answering calls from Sparklight business customers and responding to inquiries in a professional manner. • Providing accurate, prompt, and consistent support to business customer needs by following Standard Operating Procedures (SOP). • Responding to and resolving business customer situations, including billing discrepancies, in a courteous, professional manner. • Providing post-installation care, including entering changes of service into the Single View software platform. • Responding to web chat inquiries from business customers on the Business Services Website in a courteous and professional manner. • Navigating and notating back office processing tools for selected calls. • Providing timely feedback to Sparklight leadership regarding service issues or customer concerns.
• Support strategic planning by advising on state and federal health insurance markets and regulations, including: • State Medicaid plans and Medicaid managed care • Medicare, Medicare Advantage, and D-SNP plans • State waivers, pilots, and innovative care models • Value-based payment and risk-based contracting models • Quality measures for value-based purchasing • Analyze policy changes and assess implications for Activate Care’s growth strategy, care models, proposals, products, and client opportunities. • Prepare product-market fit analyses (e.g., landscape & trend analyses, policy briefs, regulatory summaries, funding authority) for new markets, contracted projects, and strategic planning. • Support Community Needs Assessments/Community Health Assessment and Equity projects by helping interpret Medicaid policy, state flexibility, coverage rules, local programs, and existing community assets. • Help determine what is feasible for health plans, providers, state agencies, and community partners to implement within existing policy, benefit, funding, and regulatory structures. • Maintain a structured opportunity pipeline for time-sensitive public-sector opportunities, including RFPs/RFIs, state funding opportunities, waiver activity, Rural Health Transformation Program (RHTP) opportunities, and emerging Medicaid or Medicare initiatives. • Develop and maintain rapid-response systems for scanning state websites, procurement portals, policy updates, public notices, and agency communications for opportunities aligned with Activate Care’s strategy. • Conduct policy-informed market research on Medicaid, Medicare, D-SNP, rural health, behavioral health, maternal health, reentry, social care, value-based care, and at-risk provider trends. • Prepare concise opportunity briefs that synthesize policy context, funding source, eligibility requirements, customer or agency need, population impact, strategic fit, feasibility, and recommended next steps. • Support go/no-go recommendations by assessing policy feasibility, operational implications, public-sector funding alignment, and fit with Activate Care’s capabilities and strategy. • Coordinate RHTP opportunities and related state or federal funding initiatives. • Serve as project manager for selected rural health and public funding workstreams, including timelines, deliverables, internal contributors, decision points, and leadership updates. • Support development of concept summaries, proposal inputs, partner briefs, and executive recommendations related to rural health transformation and other public funding opportunities. • Coordinate with appropriate functional teams (e.g., Sales/Growth, Marketing, Product, Solutions, Finance, Operations, Technology, Strategy) to determine whether opportunities should advance into proposal development, care model development, partnership exploration, or archive. • Facilitate the use of a New Concept Incubator process for proposed products/solutions, including intake, research, documentation, and decision-support process in partnership with functional teams and stakeholders. • Support evaluation of new technology products, care models, workforce models, and service innovations through policy research, regulatory review, public funding analysis, strategic fit analysis, and operational feasibility assessment. • Develop or contribute to Opportunity Analysis Briefs, including assumptions, policy and regulatory landscape, potential customers, market context, implementation feasibility, potential costs, time to market, and recommendations. • Maintain related tools and repositories, including Google Forms, Monday.com boards, Notion pages, templates, decision trees, and Slack channels. • Support semi-annual Strategic Initiatives meetings and initiative sponsors through preparation of materials, follow-up documentation, Monday.com tracking, and status updates. • Contribute to strategy regarding which markets and populations to target, including incarcerated reentry, complex medical and disabled populations, pregnant women, infants, children, and other priority groups. • Partner with Marketing by providing policy context, regulatory feasibility, funding analysis, and Medicaid/Medicare market intelligence that can inform positioning, messaging, and sales enablement. • Support proposal strategy and content by preparing policy summaries, market context, opportunity rationale, regulatory feasibility language, and strategic recommendations. • Collaborate with Product and Technology teams to share policy and market insights that may inform product roadmap discussions, solution design, or platform differentiation. • Other duties as assigned.



