Director Utilization Management Jobs in Iowa (NOW HIRING)

Position Type: Full Time

Job Location: Nevada - NV

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.

Join Liberty Dental Plan as we shape the future of dental insurance. 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.

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.

~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, managing your review queue, while maintaining quality and turnaround expectations. Engaging with colleagues and providers as needed to support accurate and consistent outcomes.

• 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.
• 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.

• 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.

Salary Range: $150,000 – $165,000 annually (final compensation will depend on experience, qualifications, and licensure).

• Competitive pay structure and savings options.
• Excellent 401(k) retirement benefits, including employer match, Roth IRA options, immediate vesting during the Safe Harbor period, and access to professional financial advice.
• Affordable medical, dental, and vision insurance with low‑cost premiums for employee‑only coverage and eligible dependents.
• Company‑paid basic life and AD&D insurance equal to one times base salary, with options to purchase 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).
• 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.

Employees are distributed across multiple markets in the United States. We do not allow employees to work outside the United States.

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.

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.

If you are a clinically strong dentist with an active Nevada & New Jersey license and a passion for improving care quality in a managed care environment, we encourage you to apply today.