Senior Quality Compliance Analyst

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Liberty Dental Plan

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2002

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Liberty Dental Plan is a U. S. -based dental insurance provider offering Medicaid (including Medi-Cal), Medicare Advantage, commercial, individual & family, and group dental plans across multiple states. The company operates member-facing services (find-a-dentist, member portal, mobile app, claims and eligibility tools) and provider-facing services (provider portal, network enrollment, claims submission, clinical guidelines, and value-based programs). Liberty Dental Plan focuses on dental benefits administration, provider network management, compliance and credentialing, and serving members, providers, and brokers.

📋 Description

• Serve as the primary intake point for compliance requests, including audits, regulatory changes, corrective actions, and business-as-usual compliance activities. • Lead and coordinate Quality and Customer Experience audits, regulatory reviews, and corrective action activities. • Conduct triage and risk-based prioritization of incoming compliance work based on regulatory, contractual, financial, and operational impact. • Research and resolve compliance issues related to CMS, state regulations, and contractual requirements. • Prepare audit materials, evidence inventories, regulatory questionnaires, audit tools, and supporting documentation for regulatory and client reviews. • Coordinate cross-functional efforts to ensure timely completion of compliance requests and audit responses. • Support the development, tracking, and monitoring of Corrective Action Plans (CAPs) and remediation activities. • Monitor regulatory and contractual changes and partner with stakeholders to implement required updates. • Manage compliance workflows, assignment tracking, ownership determination, status monitoring, and closure validation. • Analyze compliance trends, audit findings, and recurring control gaps to identify opportunities for process improvement. • Assist with the development and standardization of compliance-related policies, procedures, reporting tools, and documentation. • Collaborate with internal and external stakeholders to ensure compliance objectives and deadlines are achieved. • Perform other duties and special projects as assigned.

🎯 Requirements

• Bachelor's degree in Healthcare Administration, Public Health, Business Administration, or a related field, or an equivalent combination of education and relevant experience. • Minimum of 4 years of progressive experience in contractual compliance, audit coordination, regulatory operations, quality management, customer experience, or related functions. • Direct experience in government-managed care or another highly regulated healthcare environment. • Strong understanding of healthcare compliance requirements, including CMS, state, client, and contractual regulations. • Experience reviewing regulatory requirements and translating them into actionable operational processes and audit-ready deliverables. • Proficiency with Microsoft Office applications, including Outlook, Excel, Word, PowerPoint, and SharePoint. • Excellent organizational, analytical, critical thinking, and communication skills.

🏖️ Benefits

• 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.