Sr. Utilization Management (UM) Compliance Analyst

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

Introduction

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

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.

Qualifications

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.

Why Join Us?

Impact: