Sr. UM Compliance Analyst

Sr. UM Compliance Analyst

Fully Remote Remote - Corp - Tustin, CA 92782

Overview

Position Type Full Time Category Compliance & Audit

Description

Make an Impact Where Compliance Meets Care

At Liberty Dental Plan, we're transforming access to oral healthcareand compliance is at the heart of everything we do.

We're looking for a Sr. UM Compliance Analyst who thrives in a dynamic environment, enjoys solving complex regulatory challenges, and is ready to play a high-visibility role influencing audit outcomes, CMS alignment, and operational excellence .

If you're passionate about Medicare/Medicaid compliance, audits, and driving meaningful change , this is your opportunity to lead and make a measurable impact.

What You'll Do

You'll serve as a key partner across Compliance, UM Operations, and Client teams to ensure we meet and exceed regulatory expectations.

Compliance & Audits

• Lead and manage UM audits (internal, external, client, CMS-related)
• Identify risks, analyze findings, and drive corrective action plans (CAPs)
• Monitor remediation effectiveness and implement sustainable controls

Regulatory Expertise

• Interpret and operationalize CMS Medicare/Medicaid guidelines
• Stay ahead of regulatory changes and lead implementation efforts
• Research and resolve compliance issues with a solution-oriented mindset

Cross-Functional Influence

• Partner with Account Management, System Configuration, and Compliance teams
• Ensure UM processes, policies, and member communications (letters/templates) meet all regulatory requirements
• Collaborate with external stakeholders, including clients and regulatory entities

Reporting & Leadership Exposure

• Present audit findings and compliance insights to leadership and committees
• Support compliance training and operational excellence initiatives

What Success Looks Like

You are:

• A subject matter expert in CMS regulations
• Comfortable owning audits end-to-end
• Skilled at translating complex regulations into actionable processes
• Seen as a trusted partner and advisor
• Confident communicating with both frontline teams and executive stakeholders

What You Bring

Required:

• Bachelor's degree or equivalent experience
• 4+ years in utilization management or healthcare compliance
• Deep knowledge of CMS Medicare/Medicaid regulations
• Experience with audits and corrective action plans (CAPs)

Preferred:

• Experience in UM operations or healthcare payer environment
• Knowledge of compliance auditing frameworks and best practices
• Familiarity with tools such as HSP or Meditrac

Key Strengths We're Looking For

• Strategic thinker who can connect compliance to business impact
• Strong analytical + root cause problem-solving skills
• Exceptional communication and executive presence
• Ability to work independently and make sound decisions
• Highly organized and able to manage multiple priorities under pressure

Why Join Liberty?

• Remote flexibility
• Meaningful work impacting healthcare access and quality
• Strong collaboration across compliance, operations, and clinical teams
• Opportunity to grow within Compliance career pathways

Hiring Process

• Recruiter Screening
• Hiring Manager Interview
• Final Panel with Compliance Leadership & SMEs

Ready to Make an Impact?

If you're a compliance professional who wants to lead, influence, and elevate healthcare quality through regulatory excellence , we'd love to meet you.

Qualifications

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 annually, 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.

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