LIBERTY Dental Plan is seeking to find a Staff Orthodontist to fill our Part-Time opening (approximately 24 hours/week).

Position is open to candidates located near one of our LIBERTY offices, located in Irvine, CA, Las Vegas, NV, Oklahoma City, OK, Uniondale, NY, or Tampa, FL.

This role is primarily responsible for representing LIBERTY in any orthodontic fair hearings or provider disputes, reviewing any orthodontic specific pre-authorizations, claims, Grievance and Appeals, editing our existing orthodontic language in any Provider Reference guides, and serving as LIBERTY Dental Plan’s subject matter expert in orthodontics for all markets. LIBERTY Dental Plan currently administers commercial, Medicare Advantage and Medicaid programs in multiple states throughout the United States of America.

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  Conducts clinical review of orthodontic claims; pre-estimates and specialty care referrals, grievance and appeal review for all states (as local state regulations permit); reviews are performed emphasizing consistency with established clinical protocols, criteria and guidelines, and adjudication principles.
• 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.
• Performs other related duties as assigned.

WHAT YOU'LL NEED...

• Minimum DDS/DMD Degree required
• Minimum Orthodontic specialty certification required
• Active state dental license in good standing required (must pass credentialing – no probation or listed sanctions)
• Minimum 5 years' experience in Clinical orthodontic practice experience, experience reviewing claims preferred. Experience with commercial dental, Medicare Advantage and state Medicaid dental programs is required.
• 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.
• Bilingual / Spanish competency highly recommended (but not required).

LOCATION

Position is open to Remote or Hybrid near one of our LIBERTY office locations highly preferred. LIBERTY offices are located in Irvine, CA, Las Vegas, NV, Oklahoma City, OK, Tampa, FL, or Uniondale, NY. 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 society. That’s why LIBERTY offers competitive and attractive benefit packages for their employees. We strive to care for employees in positive ways that promotes wellness and productive employees.

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

• Competitive pay structure and saving options that help you reach your financial goals!
• Excellent 401k plan that matches 100% up to 3%. 50% match at 4% and 5%; immediate vesting during Safe Harbor period and professional financial advice through Financial Engines!
• Medical Insurance at no charge for employee only coverage. LIBERTY subsidizes 50% of eligible dependent coverage! Company offers PPO and HMO (where available) options.
• 100% paid dental coverage for your ENTIRE eligible Family members!
• 100% paid vision coverage for employee only coverage, low premium for dependents!
• Company paid basic life and AD&D coverage; options to elect additional supplemental coverage.
• Long Term Disability coverage
• Generous wellness program
• Employee Assistance Program
• 10 days paid vacation, 10 paid holidays including 2 days each for Thanksgiving, Christmas and New Years and a floating holiday granted for your birthday!
• 6 paid sick days annually with the ability to roll time over!
• Tuition Reimbursement
• Remote or Hybrid options for various positions
• And so much more...

COMPENSATION

In the spirit of pay transparency, we are excited to share the base salary for this position is $129,099 - $167,829 (salary is based on full-time (40 hours per week) schedule), exclusive of fringe benefits or potential bonuses. If you are hired at LIBERTY, your final base salary compensation will be determined based on factors such as geographic location, skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any, final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical in order to allow for future & continued 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.

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

No relocation assistance or sponsorship available at this time.