Staff Orthodontist (Part-Time)

Join Liberty Dental Plan as We Shape the Future of Dental Insurance!

LIBERTY Dental Plan is seeking a Part-Time Staff Orthodontist with an Unrestricted license or certification to practice in the State of California to join our growing team! This is an exciting opportunity for an experienced orthodontic professional to leverage their expertise in a dynamic, collaborative environment.

About the Role

As LIBERTY’s subject matter expert in orthodontics, you will play a critical role in ensuring quality care and compliance across all markets. This position focuses on Utilization Management and Review, including orthodontic claims, pre-authorizations, and grievance and appeals processes. You’ll also represent LIBERTY in orthodontic hearings, edit provider reference materials, and contribute to quality improvement initiatives.

Key Responsibilities

• Conduct clinical review of orthodontic claims, pre-estimates, and specialty care referrals.

• Review grievance and appeals cases for orthodontic services for all states (as local state regulations permit), reviews are performed emphasizing consistency with established clinical protocols, criteria and guidelines, and adjudication principles.

• Request, collect and/or analyze data as needed.

• Represent LIBERTY in orthodontic fair hearings and provider disputes.

• Edit orthodontic language in Provider Reference Guides.

• Identifies potentially unnecessary services in relation to care delivery settings.
• Identifies potential quality issues and trends in prospective and retrospective claims submissions.
• Examines clinical programs information to identify members for specific case management and/or disease management activities or interventions by utilizing established screening criteria, as needed.
• Examines dental charts for focused audits of aberrant utilization and care delivery patterns.
• Performs occasional on-site chart review for the state provider network.
• Uses clinical experience and expertise to make appropriate dental interpretations and decisions, as required.
• Meets with clients, regulators and stakeholders and communicates with them about LIBERTY’s programs as LIBERTY’s representative, when necessary.

• Participates in corporate ortho consultant training and calibration.
• Serve as a trusted advisor on orthodontic care standards and benefit administration.
• Performs other related duties as assigned.

Education & Experience

• DDS/DMD degree with orthodontic specialty certification.

• Active state dental license in good standing (must pass credentialing).

• Minimum 5 years of clinical orthodontic practice; experience reviewing claims preferred.

• Familiarity with commercial dental, Medicare Advantage, and Medicaid programs.

Skills & Knowledge

• Knowledge of orthodontic procedure codes and generally accepted clinical and adjudication guidelines on medical necessity of proposed orthodontic procedures.

  Ability to apply alternate benefits where applicable, and consistent with plan guidelines and/or generally accepted professional protocols or guidelines.

• Familiar with concepts of Utilization Management and Utilization Review
• Can take direction regarding clinical criteria and guidelines
• Ability to assimilate and apply coverage guidelines consistently
• Computer literacy with ability to easily acquire working knowledge of new system applications. Possess, at minimum, basic Microsoft (Excel, Word and PowerPoint) skills.
• Knowledge of the state and its community standards of oral health care delivery and dental care benefit administration is essential
• Project management exposure with ability to create and implement plans successfully.
• In-depth knowledge of commercial and managed care delivery systems, reimbursement mechanisms, state regulatory and legislative landscape and quality improvement initiatives.
• Ensure interactions remain positive and professional with all persons both internal and external to LIBERTY.
• Ability to recommend and/or create solutions to specific problems. Ability to analyze major objectives and break down into meaningful steps as part of a documented action plan.
• Bilingual / Spanish competency highly recommended (but not required).

• Strong understanding of orthodontic procedure codes and medical necessity guidelines.

Our PEOPLE Philosophy

At LIBERTY, we live by our PEOPLE values:

• Passion for excellence in everything we do

• Engagement with our members, providers, and communities

• Ownership of our responsibilities and outcomes

• Proactive solutions to improve oral health

• Leadership through innovation and integrity

• Empathy in every interaction

Our SMILE Leader Principles

We believe leadership starts with SMILE:

• Service: Deliver exceptional service to members and providers

• Motivation: Inspire others through commitment and integrity

• Innovation: Drive creative solutions for better oral health outcomes

• Leadership: Model accountability and excellence in every action

• Empowerment: Enable teams and individuals to succeed

Why LIBERTY?

We’re committed to innovation, quality, and improving oral health outcomes. At LIBERTY, you’ll have the flexibility of a part-time schedule while making a meaningful impact on dental care nationwide.

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 $100,000-$112,000, 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 based on a 28-hour work week. 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.