ZipRecruiter

Log In

2

Remote Hca Utilization Review Jobs in California

LIBERTY DENTAL

$74 - $82/hr

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 ...

LIBERTY DENTAL

$74 - $82/hr

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 ...

Liberty Dental Plan Careers

$74 - $82/hr

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 ...

previous pagenext page

Showing results 21-40

All JobsHca Utilization Review JobsRemote Hca Utilization Review JobsRemote Hca Utilization Review Jobs in California

Remote Hca Utilization Review information

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

What are popular job titles related to Remote Hca Utilization Review jobs in California? For Remote Hca Utilization Review jobs in California, the most frequently searched job titles are:
What job categories do people searching Remote Hca Utilization Review jobs in California look for? The top searched job categories for Remote Hca Utilization Review jobs in California are:
What cities in California are hiring for Remote Hca Utilization Review jobs? Cities in California with the most Remote Hca Utilization Review job openings:
Remote Hca Utilization Review jobs near you
Infographic showing various Remote Hca Utilization Review job openings in California as of July 2026, with employment types broken down into 90% Full Time, and 10% Contract. 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

This job post has expired today. Applications are no longer accepted.

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.

Apply