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Part Time Remote Utilization Review Jobs in California

LIBERTY DENTAL

$74 - $82/hr

Employment Type: Part-Time, Non-Exempt Work Arrangement: Fully Remote Schedule: 20 hours per week ... Experience in dental claims review, utilization management, managed care, or payer environments.

Liberty Dental Plan Careers

$74 - $82/hr

Employment Type: Part-Time, Non-Exempt Work Arrangement: Fully Remote Schedule: 20 hours per week ... Experience in dental claims review, utilization management, managed care, or payer environments.

LIBERTY DENTAL

$74 - $82/hr

Employment Type: Part-Time, Non-Exempt Work Arrangement: Fully Remote Schedule: 20 hours per week ... Experience in dental claims review, utilization management, managed care, or payer environments.

Field Materials

$111K - $137K/yr

... our part-time IT Manager, you will own the internal technology backbone of a fully remote, fast ... Manage IT vendors and renewals, perform vendor security reviews, risk assessments, and keep ...

Corvel

CA Telephonic Case Manager II

San Diego, CA · Remote

$32.18 - $48.68/hr

This is a remote part-time position. Candidates are required to have CA RN License and Compact ... Strong cost containment background, such as utilization review or managed care helpful

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All JobsUtilization Review JobsPart Time Remote Utilization Review JobsPart Time Remote Utilization Review Jobs in California

Part Time Remote Utilization Review information

What skills and qualifications are needed for a part time remote utilization review?

To thrive as a Part Time Remote Utilization Review Nurse, you need a current RN license, strong clinical judgment, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and systems such as InterQual or MCG is typically required. Excellent communication, critical thinking, and self-motivation are vital soft skills for coordinating care and making independent decisions remotely. These skills ensure accurate case evaluations, regulatory compliance, and effective collaboration with healthcare teams while working from a remote setting.

What is the difference between Part Time Remote Utilization Review vs Part Time Remote Claims Reviewer?

AspectPart Time Remote Utilization ReviewPart Time Remote Claims Reviewer
CredentialsTypically requires healthcare licenses (e.g., RN, MD) and utilization review certificationsUsually requires insurance or claims processing experience, with some industry-specific certifications
Work EnvironmentRemote, healthcare-focused, reviewing medical necessity and appropriateness of careRemote, insurance or healthcare claims processing, verifying coverage and claims accuracy
Employer & Industry UsageHospitals, insurance companies, healthcare organizationsInsurance companies, third-party administrators, healthcare payers

Part Time Remote Utilization Review and Part Time Remote Claims Reviewer both operate remotely but focus on different aspects of healthcare administration. Utilization reviewers assess medical necessity, while claims reviewers verify insurance claims. Understanding these differences helps job seekers find roles aligned with their skills and credentials.

What is a part time remote utilization review?

A Part Time Remote Utilization Review position involves evaluating medical records and healthcare services to ensure they are necessary and appropriate, typically for insurance companies or healthcare providers. This job is performed remotely, allowing professionals to work from home or another location outside of a traditional office setting. Part-time roles generally require fewer hours than full-time positions, making them suitable for those seeking flexible schedules. Professionals in this role often have backgrounds in nursing or healthcare and use their expertise to review patient care for quality and cost-effectiveness.

What challenges do part time remote utilization review professionals face, and how can they be managed?

Part-time remote utilization review professionals often face challenges such as balancing a variable workload, ensuring timely communication with healthcare providers, and staying current with changing insurance guidelines. Since much of the work is done independently, strong time management and self-motivation are essential to meet review deadlines. Regularly scheduled check-ins with the team and utilizing digital collaboration tools can help maintain connectivity and support. Staying organized and proactive in seeking clarification when needed can mitigate common challenges and lead to a successful experience in this role.
What are the most commonly searched types of Remote Utilization Review jobs in California? The most popular types of Remote Utilization Review jobs in California are:
What are popular job titles related to Part Time Remote Utilization Review jobs in California? For Part Time Remote Utilization Review jobs in California, the most frequently searched job titles are:
What job categories do people searching Part Time Remote Utilization Review jobs in California look for? The top searched job categories for Part Time Remote Utilization Review jobs in California are:
What cities in California are hiring for Part Time Remote Utilization Review jobs? Cities in California with the most Part Time Remote Utilization Review job openings:
Part Time Remote Utilization Review jobs near you
Infographic showing various Part Time Remote Utilization Review job openings in California as of July 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution.

Staff Dentist (Part-Time, Remote, California License)

LIBERTY DENTAL

On-site, Remote

$74 - $82/hr

Part-time

Medical, Dental, Retirement, PTO

Posted 12 days ago

Job description

Help Shape Better Oral Health Outcomes at Liberty Dental Plan
At Liberty Dental Plan, our mission is to improve oral health by delivering high-quality, accessible, and cost-effective dental benefits. We are seeking an experienced Staff Dentist to join our clinical team and play a critical role in supporting our Utilization Management (UM) and Utilization Review (UR) programs.
This fully remote opportunity offers a consistent 20-hour-per-week schedule, allowing experienced dentists to apply their clinical expertise in a collaborative managed care environment while helping improve access to high-quality oral healthcare. You will review dental claims, prior authorizations, referrals, and treatment requests across Commercial, Marketplace Exchange, Medicare Advantage, and Medicaid populations, helping ensure members receive appropriate, evidence-based care while supporting quality outcomes and regulatory compliance.
About the Role
The Staff Dentist is responsible for performing timely, accurate, and clinically sound reviews of dental claims and service requests. Working closely with providers, dental leadership, and cross-functional teams, you will support consistent coverage determinations, quality improvement initiatives, and exceptional member experiences.
Employment Type: Part-Time, Non-Exempt
Work Arrangement: Fully Remote
Schedule: 20 hours per week
Compensation: $74.00 - $82.00 per hour
What You'll Do
Utilization Management & Clinical Review
  • Review dental claims, referrals, and prior authorization requests across multiple lines of business.
  • Apply clinical expertise to evaluate treatment plans, radiographs, chart notes, and supporting documentation.
  • Make coverage determinations based on benefit plans, clinical guidelines, medical necessity criteria, and applicable policies.
  • Meet established productivity, quality, and turnaround-time standards.
  • Document clinical rationale clearly and accurately in accordance with regulatory and accreditation requirements.
Clinical Quality & Consistency
  • Participate in calibration sessions to promote consistency and accuracy in clinical decision-making.
  • Complete inter-rater reliability assessments and support ongoing quality improvement efforts.
  • Collaborate with leadership and peers to address complex clinical scenarios and interpretation questions.
  • Incorporate audit findings and feedback to continuously enhance determination accuracy and documentation quality.
Provider Engagement & Peer Collaboration
  • Conduct peer-to-peer consultations with treating providers regarding clinical determinations and treatment alternatives.
  • Participate in grievance, appeal, and secondary review activities.
  • Consult with dental specialists and subject matter experts as needed to support informed clinical decision-making.
Regulatory & Operational Support
  • Maintain expertise in Liberty Dental Plan benefit structures and applicable Medicaid programs.
  • Support regulatory reporting and accreditation-related activities.
  • Stay current with ADA CDT coding updates, evidence-based treatment guidelines, and state-specific requirements.
  • Participate in required training programs, departmental meetings, and organizational initiatives.
What You'll Bring
Required Qualifications
  • DDS or DMD degree from an accredited dental school.
  • Current, active, and unrestricted California dental license in good standing.
  • Minimum of six (6) years of experience as a practicing dentist.
  • Ability to successfully complete Liberty Dental Plan credentialing and recredentialing requirements.
  • Strong knowledge of dental procedures, clinical guidelines, coding standards, and medical necessity criteria.
  • Ability to review and interpret dental radiographs, treatment plans, and chart documentation.
  • Excellent written and verbal communication skills.
  • Ability to manage review volumes efficiently while maintaining quality and compliance standards.
Preferred Qualifications
  • Experience in dental claims review, utilization management, managed care, or payer environments.
  • Experience training, coaching, or mentoring clinical peers.
  • Familiarity with claims adjudication systems and clinical review platforms.
  • Experience with AI-assisted review technologies such as Overjet or similar solutions.
  • Exposure to project management and quality improvement initiatives.
Knowledge, Skills & Abilities
  • Understanding of commercial, Medicare, Medicaid, and managed care dental programs.
  • Knowledge of reimbursement methodologies, utilization management principles, and regulatory requirements.
  • Ability to clearly communicate and support evidence-based clinical determinations.
  • Strong computer proficiency and the ability to quickly learn new technology platforms.
  • Ability to work effectively in a collaborative, team-oriented environment.
  • Commitment to maintaining all required licensure and continuing education requirements.
Why Join Liberty Dental Plan?
  • Make a meaningful impact on the oral health of diverse member populations.
  • Apply your clinical expertise in a collaborative, mission-driven organization.
  • Help drive quality, consistency, and innovation in dental utilization management.
  • Work alongside experienced dental and healthcare professionals dedicated to improving access to care.
  • Enjoy the flexibility of a fully remote position with a predictable 20-hour-per-week schedule and competitive hourly compensation.
Ready to Make an Impact?
If you are a licensed California dentist passionate about clinical excellence, evidence-based decision-making, and improving oral health outcomes, we encourage you to apply today and join Liberty Dental Plan's dedicated clinical team.
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.
  • 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.
  • Paid company holidays.
  • Remote or hybrid work options available for various positions.

Compensation
In the spirit of pay transparency, the base salary range for this position is $74.00 - $82.00 an hour, 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.

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