Dental Consultant Reviewer

About Company:

Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years.

We are leaders in assisting front-line providers and engaging health care partners to improve care delivery and patient outcomes.

Comagine Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. We are proud to be a Recovery Friendly Workplace, supporting the health and well-being of all employees.

We are seeking an experienced Dental Consultant Reviewer licensed and must reside 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.

Key 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

Qualifications:
* 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
* Experience with prior authorization, utilization review, or Medicaid dental policy preferred