L

Sr. Utilization Management (UM) Compliance Analyst

LIBERTY Dental Plan Corporation
Full-time
On-site
Tustin, California, United States
Join to apply for the Sr. Utilization Management (UM) Compliance Analyst role at Liberty Dental Plan

Overview
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.

Job Summary / Responsibilities

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.

Qualifications

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

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

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 is a plus

Why Join Us

Impact: Play a vital role in ensuring regulatory standards and delivering quality, compliant care

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

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

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

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

Competitive pay structure and savings options

Excellent 401(k) retirement benefits, including employer match

Affordable medical insurance with employer-subsidized dependent coverage

100% employer-paid dental coverage for employees and eligible dependents

Vision insurance with low-cost premiums

Company-paid basic life and AD&D insurance

Flexible Spending Accounts for healthcare and dependent care

Voluntary benefits (accident, critical illness, hospital indemnity)

Long-term disability and expansive wellness programs

Employee Assistance Program (EAP)

Generous vacation and sick leave policies, with rollover options

10 paid company holidays

Tuition reimbursement for eligible educational expenses

Remote or hybrid work options available

Compensation
Base salary range: $70,000 – $90,000, not including fringe benefits or potential bonuses. Final salary determined by location, skills, education, and experience. Liberty is committed to pay equity and considers internal equity in final decisions. Offers are typically not made at the top of the range to allow for future growth.

Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled. No relocation assistance or sponsorship available at this time.

#J-18808-Ljbffr
Apply now
Share this job