Sr. UM Compliance Analyst

LIBERTY DENTAL PLAN CORPORATION•Tustin, CA

2d•$70,000 - $90,000•Remote

About The Position

At Liberty Dental Plan, we’re transforming access to oral healthcare—and 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.

Requirements

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)

Nice To Haves

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

Responsibilities

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

Benefits

Competitive pay structure and savings options
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.