Staff Dentist (1099 Independent Contractor 6 Month Assignment | Fully Remote)

July 11, 2026

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Fully Remote Shrewsbury, NJ or Uniondale, NY

About the Role

We are seeking an experienced Staff Dentist (1099 Independent Contractor) to support Utilization Management (UM) and Utilization Review (UR) functions across our dental plans. This is a fully remote, non-clinical, review-focused role ideal for dentists who want to apply their clinical expertise to drive quality, compliance, and appropriate care delivery at scale.

In this role, you will perform clinical reviews of claims, prior authorizations, and referrals across Commercial, Medicare Advantage, and Medicaid lines of business, helping ensure regulatory compliance, cost-effective care, and high-quality oral health outcomes.

Assignment Details

Work Type: 100% Remote (U.S.-based)
Contract Type: 1099 Independent Contractor
Duration: 6-month assignment with potential for extension
Schedule: Flexible, based on business needs
Licensure: Active, unrestricted dental license in California or New Jersey is required; candidates without one of these state licenses will not be considered

Key Responsibilities

Utilization Management & Clinical Review

Perform timely clinical adjudication of dental claims and prior authorization requests
Determine medical necessity and benefit coverage using clinical expertise and plan guidelines
Interpret radiographs, charts, and supporting documentation to inform decisions
Identify inappropriate, unnecessary, or low-value services

Quality Management & Improvement

Participate in quality improvement initiatives, audits, and utilization analyses
Conduct focused chart reviews to identify utilization trends and potential quality concerns
Support SIU activities, including provider site reviews and corrective recommendations
Analyze treatment patterns and recommend improvements

Provider Engagement & Peer Review

Conduct peer-to-peer consultations with network providers
Participate in grievance, appeal, and secondary review processes
Collaborate with specialists or subject-matter experts as needed

Collaboration, Training & Committees

Participate in calibration sessions, trainings, and interrater reliability activities
Attend clinical and operational meetings
Contribute to credentialing and quality committees
Support resolution of provider and member concerns

Tele-Dentistry & Clinical Support

Provide clinical input during tele-dentistry consultations when needed

Regulatory & Subject Matter Expertise

Maintain expertise in dental benefit plans and Medicaid program requirements
Support regulatory reporting and compliance initiatives

Qualifications

DDS or DMD from an accredited dental school
Active, unrestricted dental license in good standing in a U.S. state
Minimum:
- 4+ years practicing as a dentist
- 2+ years experience with claims review, utilization management, or payer-side dentistry preferred
Strong knowledge of:
- Dental coding and clinical guidelines
- Managed care and reimbursement systems
- Medical necessity criteria and adjudication processes
Ability to interpret radiographs and dental records
Strong analytical, decision-making, and communication skills
Current professional malpractice insurance required (must be maintained throughout the contract period)

Work Environment & Structure

Fully remote, computer-based role
Work is primarily sedentary and requires extended screen time
Flexible scheduling aligned with business needs
1099 contractor position (no employee benefits)

What Makes You a Strong Fit

You bring a clinical lens to business decisions, balancing quality, cost, and compliance
You are detail-oriented and consistent in applying guidelines and policies
You communicate effectively in peer-to-peer provider discussions
You thrive in a collaborative, healthcare environment

Why Join

Fully remote opportunity with flexible scheduling
Apply your clinical expertise beyond the operatory
Influence care quality and outcomes at a population level
Work on meaningful, mission-driven initiatives
Opportunity for contract extension based on performance and business needs

How to Apply

Submit your resume, licensure details, and proof of current malpractice insurance to be considered for this opportunity.

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