Careers

Grievance Analyst - Irvine, CA

07/09/2014

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.

Eligibility Specialist - Irvine, CA

07/09/2014

Summary

The Eligibility Specialist is responsible for updating the membership database, creating spreadsheets, and conducting data analysis. 

Data Entry Clerk - Las Vegas, NV & Tampa, FL

07/09/2014

Summary

Responsible for entering data from hard copy to KFI (key from image) and verifying provider or member information on EDI (Electronic Data Interchange) claim submissions.

 

Quality Assurance Analyst - Irvine, CA

07/09/2014

Summary: 

This position will evaluate all call center and referral employees to ensure they are delivering the highest level of service to the customer and will act as a change agent to improve the quality of the customer service provided. This will be accomplished by conducting quality reviews and audits to identify strengths and deficiencies, ensuring call accuracy, regulatory compliance, and overall superior customer service.  All results will be recorded using the call quality program guidelines and quality monitoring system. Responsible for creating, updating and maintaining dashboards as required.  This position will develop and produce statistical reports, identify weaknesses in procedures or processes and identify training needs. At a minimum, each employee will be evaluated ten times each month.  Specific client requirements will be accommodated as appropriate.

Provider Relations Representative - Greater Chicago Area

07/09/2014

Summary

Individual will be responsible for developing strong provider network, recruiting and retaining network providers, training and educating providers to ensure compliance with LIBERTY’s policies and procedures. In need of a dedicated Network Manager with Medicaid experience and knowledge of programs in Illinois.

Internal Auditor - Irvine, CA

07/09/2014

Summary

This position is responsible for auditing of claims processing, specialty care referrals, group set up, performance guarantee groups, compliance reporting for specified groups, schedule of benefits and provider fee schedules at an individual, group as well as company-wide levels.  

Accounts Receivable Staff Accountant

07/09/2014

Summary

AR Staff Accountant will be responsible in monitoring cash receipt to ensure Liberty receive the payment accurately and timely.

Corporate Recruiter - Irvine, CA

07/09/2014

Summary

This is an exciting opportunity for an experienced Corporate Recruiter to join a dynamic organization during a period of rapid growth. Use your energy and drive to help us hire the best and the brightest for LIBERTY Dental Plan.  We are interested in candidates who have the unique ability to identify quality candidates with not only the technical skills, but are a good fit for our teams and culture at all levels. The Corporate Recruiter will partner with managers to anticipate and meet the evolving needs of the organization to deliver best talent in the organization. The position will nurture relationships with prospective talent and manage on-going manager relationships all while having FUN doing it! We are a true contributor to the growth of the company and we provide the talent that makes this company successful.

Account Manager - Cook County, IL

07/09/2014

Summary

The Account Manager serves as the primary contact for clients and is focused on retention and client satisfaction. This person will be responsible for developing and maintaining long-term relationships with assigned clients and acting as a liaison between such clients and the operational components of the company.

Manager, Provider Relations - Cook County, IL

07/22/2014

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. Must be a self-starter, results driven, and interested in a fast paced environment. 

Professional Services Coordinator-Irvine, CA

06/02/2014

Summary

This position is responsible for processing of provider contracts, maintenance of provider database and providing support to the Supervisor of Administrative Services as well as Professional Relations management team.  

Audit/Compliance Coordinator-Irvine, CA

04/25/2014

Summary

The Audit/Compliance Coordinator will be responsible for carrying out duties related to the ongoing administration of various Quality Management (QM)-related initiatives, programs, meetings and activities while coordinating various ongoing compliance activities as needed. 

Director of Member Services-Las Vegas, NV

05/08/2014

Summary

The Director of Member Services will have overall strategic and operational responsibility for Member Services and reports to the VP, Member Services.

This position gives direction and leadership toward the achievement of the organization’s philosophy, mission, strategy and its goals and objectives.  Responsible for managing daily activities of Member Services and Fulfillment departments while ensuring the highest level of customer satisfaction, accuracy and compliance with all reporting benchmarks.  Also oversees long-term planning, technology strategies and continuous improvement of operational efficiencies.  Keeps current on State and Federal regulatory issues and industry activities and trends and is responsible for regulatory reporting.  Diligently works to foster a positive and cohesive work environment, while ensuring exemplary service is provided to all customers.

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.

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.

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.