Utilization Management Auditor Jobs in California

At Liberty, we are committed to improving lives by expanding access to quality dental care. Our culture emphasizes collaboration, integrity, and accountability-and our People Philosophy centers on empowering employees to thrive while making a meaningful difference for the members and communities we serve.

Help protect integrity, strengthen compliance, and improve how we serve our members.

At Liberty Dental Plan, our Internal Audit team plays a critical role in ensuring accuracy, compliance, and operational excellence across our organization. We are looking for a detaildriven, analytical Sr. Internal Auditor who brings strong claims or audit experience and a collaborative mindset to help support regulatory readiness, claims accuracy, and continuous improvement across the enterprise.

If you enjoy digging into data, identifying trends, and working crossfunctionally to drive quality and accountability, this role offers meaningful impact in a missiondriven organization.

What You'll Do

As a Sr. Internal Auditor, you will support daytoday audit activities across claims, utilization management, and system configuration while playing an important role in regulatory compliance and quality improvement initiatives.

Key Responsibilities

• Audit and analyze claims data to ensure processing accuracy and servicelevel standards are met at individual, group, and enterprise levels.
• Review claims processing, specialty referrals, prior authorizations, benefit plans, group setup, and system configuration to confirm alignment with contracts and policies.
• Validate benefit schedules, frequency limits, and provider compensation schedules to ensure accurate system configuration and payments.
• Create and maintain claims and UM client file packets used for external audits and internal reviews.
• Support CMS ODAG and CMS Part C audits, including file preparation, tracking, and data validation activities.
• Analyze audit results, identify trends, and document findings to support training, calibration, and continuous improvement efforts.
• Collaborate with Claims, UM, Compliance, IT, and other departments to follow up on audit findings and ensure timely corrections.
• Support and test automation tools and internal bots to help meet regulatory and client requirements.
• Assist with departmental reporting, training activities, and the development or refinement of audit policies and procedures.
• Maintain professionalism and confidentiality when handling sensitive audit information.
• Perform additional duties as assigned. 

What Makes This Role a Senior Opportunity

• Participation in CMS ODAG and Part C audits
• Primary contributor to UM and Claims file packet creation
• Involvement in quality improvement initiatives and system enhancement discussions with leadership and IT
• Opportunity to influence audit practices and support multiple departments through shared audit resources.

What You Bring

Experience & Education

• Preferred Bachelor's degree or equivalent combination of education and relevant experience
• Minimum 2 years of experience in claims processing, claims auditing, or claims data analysis (Dental PPO or DHMO environment strongly preferred)
• 1+ year of internal audit experience, preferably within a dental or healthcare setting 

Skills & Knowledge

• Strong understanding of dental claims processing and audit methodologies
• Proficiency in Microsoft Word and Excel
• Strong analytical, reporting, and trendanalysis skills
• Excellent attention to detail and comfort working with complex data
• Ability to work independently while managing multiple priorities
• Strong written and verbal communication skills
• Discretion and professionalism when handling confidential information
• Collaborative mindset with the ability to promote teamwork across departments 

Why Liberty Dental Plan

At Liberty, we are committed to improving lives by expanding access to quality dental care. Our culture emphasizes collaboration, integrity, and accountability-and our People Philosophy centers on empowering employees to thrive while making a meaningful difference for the members and communities we serve.

This role offers the opportunity to:

• Work remotely in a supportive, missiondriven environment
• Partner closely with Compliance, Claims, UM, and IT teams
• Contribute to regulatory readiness and operational excellence
• Grow your audit expertise within a reputable dental benefits organization

Location

Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.

What Liberty Offers

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their communities. That's why Liberty offers competitive and attractive benefit packages for our employees. We strive to care for employees in ways that promote wellness and productivity.

Our first-class benefits package supports employees and their dependents with:

• 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.

Compensation

In the spirit of pay transparency, the base salary range for this position is $24 - $28 an hour not including fringe benefits or potential bonuses. At Liberty, your final base salary will be determined by factors such as geographic location, skills, education, and experience. We are committed to pay equity and also consider the internal equity of our current team members when making final compensation decisions.

Please note that the range listed represents the full base salary range for this role. Typically, offers are not made at the top of the range to allow for future salary growth.

Liberty Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. Liberty will leverage diverse perspectives in building high performance teams and organizational culture. 

Liberty Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve. 

We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

Sponsorship and Relocation Specifications

Liberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.

All your information will be kept confidential according to EEO guidelines.