Careers

Regional Dental Director-Tampa, FL

03/14/2014

Summary

This position will be primarily responsible for representing LIBERTY Dental Plan to our health plan partner, and to be the “clinical presence” of LIBERTY in the Florida regional office, meeting with FL clients, responding to urgent requests for dental services, assisting the Internal Response Unit (IRU) with expedited case management issues as needed.  Routinely, the Dental Director will perform adjudication of dental claims and prospective requests for dental services (referrals and pre-authorizations) in Florida along with other Dental Consultants.  Additionally, this person will participate in other clinical review activities in Florida, such as participating in Florida Quality Management and Improvement activities such as clinical review of FL grievances, and meeting with FL clients for periodic joint operational meetings.  The position will be full or part time (two to four days per week at inception) depending on volume and demand.  The FL Dental Director also participates actively in Utilization Management and Review Programs.  LIBERTY Dental Plan administers commercial, Medicare Advantage and Medicaid programs in Florida.

The Dental Director will report to the National Dental Director and will collaborate with other corporate Dental Directors to assist in the development of clinical guidelines and Qualify Management Improvement processes to ensure process improvement and consistency in all clinical activities across the enterprise, yet specializing in any unique FL requirements. 

The FL Dental Director will be an active participant on the National Peer Review Committee in reviewing and analyzing Potential Quality Issues (PQIs), a member of Utilization Management Committee, Credentialing Committee and Quality Management & improvement Committee.

Quality Management Coordinator II - Irvine, CA

03/20/2014

Summary

The QM Coordinator II will be responsible for supporting the functions of the QM Department.  In this role, the ideal candidate will be experienced in handling a wide range of administrative tasks and will be able to work independently with little, to no supervision. This person must be professional, exceedingly well organized, and flexible.  Must excel and enjoy the administrative challenges of supporting a busy department of diverse people, programs and initiatives.

The ability to function effectively and efficiently in a fast paced environment, often under pressure, remaining flexible and resourceful while maintaining a high level of professionalism and confidentiality is crucial to this role.  This role requires maintaining a high degree of data entry accuracy while consistently adhering to strict internal and regulatory timeframes.

Dental Director - Tampa, FL

02/18/2014

Summary

This position will be primarily responsible for the adjudication of dental claims and prospective requests for dental services (referrals and pre-authorizations) in Florida.  Additionally, this person will participate in other clinical review activities in Florida, such as participating in Florida Quality Management and Improvement activities such as clinical review of FL grievances, and meeting with FL clients for periodic joint operational meetings.  The position will be full or part time depending on volume and demand.  The FL Dental Director also participates actively in Utilization Management and Review Programs.  LIBERTY Dental Plan administers commercial, Medicare Advantage and Medicaid programs in Florida.

The Dental Director will report to the National Dental Director and will collaborate with other corporate Dental Directors to assist in the development of clinical guidelines and Qualify Management Improvement processes to ensure process improvement and consistency in all clinical activities across the enterprise, yet specializing in any unique FL requirements. 

The FL Dental Director will be an active participant on the National Peer Review Committee in reviewing and analyzing Potential Quality Issues (PQIs), a member of Utilization Management Committee, Credentialing Committee and Quality Management & improvement Committee

Member Services Representative - Las Vegas, NV & Tampa, FL

02/18/2014

Summary

Member Services Representatives (MSRs) are expected to provide excellent customer service to all incoming callers and will answer inquiries related to; dental benefits, eligibility, provider information, claims, grievance and appeals, fulfillment requests and other miscellaneous inquiries. MSRs must observe all local, state and federal guidelines and regulations.

Professional (Provider) Relations - Irvine, CA

02/18/2014

Summary:

LIBERTY Dental Plan has an immediate need for an experienced Manager to oversee our growing Professional Relations Department for our West Coast territories. This department manages the functions related to dental provider network development, contracts, education and servicing. If you are a self-starter, results driven, and interested in a fast paced company that still offers a good work life balance, this is the position for you!

Healthcare Underwriting Risk Analyst - Irvine, CA

02/18/2014

Summary: 

The Risk Analyst supports the establishment of market rates, reserve estimates, trend projections and other financial determinations for assigned markets and blocks of business.  The position requires independent analysis and the ability to think “outside the box” and continually consider new ideas and methodologies.  The position demands that the analyst relies on experience and judgment to plan and accomplish goals.

Grievance Analyst I - Irvine, CA

02/21/2014

Summary: 

The Grievance Analyst I will be responsible for intake of all member, provider and Health Plan Partner grievances and appeals.  In addition, the Grievance Analyst I will investigate and resolve certain member, provider and Health Plan Partner grievances and appeals.

Member Services Manager - Irvine, CA

02/21/2014

Summary: 

Oversees daily operations of the call center and Member Services Representatives (MSRs) and related employees to ensure goals and objectives are met or exceeded. Monitor and participate in the development, implementation, enhancement and support of call center systems, technologies and strategies. Diligently works to foster a positive and cohesive work environment, while ensuring exemplary service is provided to all customers. This position is also responsible for oversight of the Fulfillment department.