Sr. Utilization Management

Empower compliance excellence. Drive quality care. Make an impact.

At Liberty Dental Plan, we believe that compliance isn't just about meeting regulations — it's about ensuring our members receive the highest quality care possible. We're looking for a Senior Utilization Management (UM) Compliance Analyst who's ready to lead with integrity, bring precision to process, and play a critical role in supporting our mission to deliver compliant, effective, and compassionate healthcare solutions.

Whether you're an internal team member looking to grow your career or an experienced professional seeking a purpose-driven organization, this is your opportunity to make a real difference.

As our Senior UM Compliance Analyst, you'll serve as the cornerstone of compliance within Utilization Management operations. You will:

• Lead and coordinate client and external audits for UM Operations, including managing all audit activities, reporting outcomes, and driving continuous improvement.
• Develop and respond to Corrective Action Plans (CAPs) by identifying root causes, implementing solutions, and monitoring for sustained compliance.
• Partner closely with the Liberty Compliance Department to review and refine policies, procedures, and operational practices.
• Support and train UM staff to ensure understanding and adherence to CMS and State regulatory requirements.
• Track and report UM performance metrics to leadership and committee teams.
• Stay current with evolving CMS and State guidelines, ensuring timely updates and organizational readiness.
• Collaborate with Account Management, System Configuration or other areas to review UM letter templates to ensure they meet regulatory, clinical and operational requirements.
• Take a lead role in the development, maintenance and publishing of internal/external policies and procedures

This is a dynamic role for someone who thrives in a collaborative environment, enjoys problem-solving, and is passionate about safeguarding compliance excellence in healthcare operations.

Education:

• Bachelor's Degree in Healthcare Administration, Public Health, Business Administration, or a related field (or equivalent experience)

Experience:

• Minimum of 4 years in Utilization Management or healthcare compliance, with a focus on CMS Medicaid and Medicare guidelines

Skills & Knowledge:

• Deep understanding of CMS regulations, policies, and reporting for Medicare and Medicaid.
• Strong analytical and organizational skills with keen attention to detail.
• Exceptional written and verbal communication and interpersonal abilities — capable of building trust and collaborating effectively across teams.
• Proficiency in Microsoft Office Suite (Outlook, Excel, Word, SharePoint, PowerPoint).
• Familiarity with compliance programs, auditing processes, or systems like HSP / Meditrac a plus.

Impact: Play a vital role in ensuring our organization meets the highest regulatory standards and delivers quality, compliant care.

Growth: Expand your expertise in compliance leadership while collaborating with skilled professionals across departments.

Culture: Be part of a supportive, mission-driven team that values integrity, innovation, and accountability.

Recognition: Your insights and initiative will directly contribute to the success of Liberty's UM operations and compliance excellence.

If you're ready to take the next step in your compliance career and help shape the future of healthcare operations — we want to hear from you

Apply today and bring your expertise to where it truly makes a difference.

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.
• Affordable medical insurance, with low-cost premiums for employee-only coverage. Liberty subsidizes the cost for eligible dependents enrolled in the plan.
• 100% employer-paid dental coverage for employees and eligible dependents.
• Vision insurance with low-cost premiums for employee-only coverage and dependents.
• Company-paid basic life and AD&D insurance, equal to one times your base salary, with options to purchase additional supplemental coverage.
• Flexible Spending Accounts for healthcare and dependent care expenses.
• Voluntary benefit programs, including accident, critical illness, and hospital indemnity insurance.
• Long-term disability coverage.
• Expansive wellness programs, including company-wide wellness challenges, BurnAlong memberships, and gym discounts.
• 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.
• 10 paid company holidays.
• Tuition reimbursement for eligible educational expenses.
• Remote or hybrid work options available for various positions.

Compensation

In the spirit of pay transparency, the base salary range for this position is $70,000 - $90,000, 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.