Dental Review Consultant

Blue Cross Blue Shield of MA

Hingham, Massachusetts, United States
Base: $120.32 - $147.06 ph; bonus/equity: eligible...
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Licensed dentist in massachusetts
Evaluate clinical necessity of procedures
Review cdt codes and treatment plans
** Blue Cross Blue Shield of MA is seeking a part-time Dental Review Consultant to ensure the clinical integrity and accuracy of dental service reviews. The ideal candidate will hold a current dental license in Massachusetts and possess strong clinical and analytical skills to evaluate dental treatment documentation. **

Job Summary

  • This part-time position is responsible for ensuring the clinical integrity, accuracy, and consistency of dental service reviews.
  • The role involves evaluating documentation for clinical dental services to ensure they represent necessary and appropriate care for members.
  • Candidates will benefit from a reduced physical strain compared to clinical practice while affecting dental care on a larger scale.

Matching Summary

Match Score: 75

** Blue Cross Blue Shield of MA is seeking a part-time Dental Review Consultant to ensure the clinical integrity and accuracy of dental service reviews. The ideal candidate will hold a current dental license in Massachusetts and possess strong clinical and analytical skills to evaluate dental treatment documentation. **

Salary

Base: $120.32 - $147.06 per hour; Bonus/Equity: Eligible for variable pay; Benefits: Comprehensive package including PTO, medical/dental/vision, 401(k)

Skills & Requirements

Must-have

  • Licensed dentist in Massachusetts
  • Evaluate clinical necessity of procedures
  • Review CDT codes and treatment plans
  • Communicate with dental providers
  • Apply evidence-based clinical guidelines

Nice-to-have

  • Prior utilization review experience
  • Experience with managed care principles
  • Strong analytical and critical thinking
  • High ethical integrity standards
  • Meticulous attention to detail

Key Requirements

  • Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD)
  • Current unrestricted dental license in Massachusetts
  • Significant experience in clinical setting as general dentist
  • Knowledge of dental coding systems (CDT)

Work Rights

Must have valid Massachusetts dental license

Tailored Resume

Cover Letter