Jobs at LIBERTY Dental Plan

Maintains general ledger records, prepares journal entries and reconciliations, supports month-end and annual close, analyzes budget variances, prepares financial reports, assists with audits, resolves accounting discrepancies, and collaborates cross-functionally on financial and process improvement initiatives.

Provides advanced administrative support for provider network recruitment, maintenance, verification, contracting, communications, and escalated inquiries. Troubleshoots provider portal issues, audits contracts and terminations, maintains rosters and operational reports, coordinates meetings and projects, researches network processes, and mentors junior staff. The role requires strong organization, communication, customer service, compliance, and dental provider network expertise.

Configure, test, and maintain claims and Utilization Management (UM) system logic. Analyze complex claim/UM scenarios, support benefit implementation, audit system rules and benefit setups, coordinate cross-functional implementations and member notifications, support Crystal Reports, and document policies and procedures.

Leads dental provider network recruitment, retention, contracting, fee schedule management, performance improvement, and provider service initiatives. Manages Provider Relations staff, develops performance standards, supports hiring and training, resolves provider issues cross-functionally, prepares reports, and advises executive leadership. Requires knowledge of healthcare payment methodologies, regulatory compliance, dental networks, and government dental programs. Travel up to 50% is required.

Leads client onboarding and implementation projects, manages and develops implementation teams, oversees project portfolios, mitigates risks, improves processes, and ensures operational readiness and successful transitions to account management. Partners cross-functionally to deliver complex implementations, establish scalable methodologies, monitor performance, and enhance client experiences.

Maintain and support enterprise applications across environments by coordinating with vendors and teams, troubleshooting and resolving defects, managing deployments, performing code reviews, and supporting Azure/.NET/SQL-based web applications and secure file transfer (FTP/SFTP/FTPS/MOVEit). Drive continuous improvement, configuration management, and adoption of new technologies.

Lead the Grievance & Appeals department to ensure timely, compliant resolution of member and provider disputes. Oversee operations, regulatory compliance, audits, reporting, root-cause analysis, corrective actions, quality committees, regulatory filings, stakeholder communication, and continuous improvement while managing and developing staff.

Process dental claims, pre-authorizations, referrals, and benefit determinations within service level agreements. Adjudicate COB and orthodontic claims, perform high-volume data entry, maintain regulatory and procedural knowledge, collaborate across teams to resolve claim issues, and meet productivity and quality standards in a remote environment.

Support Medicaid and Medicare quality programs by managing projects, ensuring regulatory compliance, analyzing program data, reporting performance, coordinating cross-functional improvement efforts, and supporting accreditation and audit readiness.

Serve as liaison between business and IT to gather requirements, analyze systems, identify gaps, design and support solutions (RPA, APIs, web apps), document changes, troubleshoot issues, and drive continuous process improvement.

Lead and grow a systems engineering team to design, validate, and operate enterprise infrastructure. Own requirements management, architecture reviews, verification/validation, risk management, and cross-functional collaboration to ensure secure, reliable, and high-performing systems while driving process improvements and compliance.