About The Position

We are seeking an experienced Dental Consultant Reviewer licensed in Alabama to provide clinical expertise supporting dental prior authorization reviews and policy interpretation for Alabama Medicaid oral health services. In this role, you will review dental service requests, apply established clinical criteria, and ensure compliance with Alabama Medicaid policies and standards. This position is ideal for a practicing dentist interested in contributing their expertise on a PRN / on-call basis while helping ensure appropriate utilization and quality oversight of dental services.

Requirements

  • DDS or DMD from an accredited dental school
  • Active Alabama dental license in good standing
  • Must reside in Alabama
  • 5+ years of experience practicing dentistry

Nice To Haves

  • Experience with prior authorization, utilization review, or Medicaid dental policy preferred

Responsibilities

  • Review and process dental prior authorization (PA) requests
  • Apply Alabama Medicaid clinical criteria and guidelines
  • Approve or deny requests with clear clinical documentation
  • Ensure consistent application of Medicaid policy across reviews
  • Provide clinical insight to support provider relations and reporting activities

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What This Job Offers

Job Type

Part-time

Career Level

Mid Level

Education Level

Ph.D. or professional degree

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