Senior Manager, Utilization Management (UM) Operations

The Senior Manager, Utilization Management (UM) Operations provides strategic and operational leadership to ensure timely, accurate, and compliant processing of authorizations, referrals, and clinical review activities. This role oversees daily UM operations, ensures compliance with service level agreements (SLAs) and regulatory requirements, and partners cross‑functionally to support departmental and organizational goals while maintaining audit readiness across UM functions.What You’ll DoIn This Role, You WillPromote a positive, collaborative, and high‑engagement team culture rooted in trust, continuous learning, and service excellenceLead, coach, and mentor UM managers and staff to drive effective performance, consistency, and accountability across all UM functionsOversee recruiting, hiring, onboarding, training, and talent development of UM team membersDefine and communicate performance expectations, KPIs, productivity standards, and quality metrics; conduct performance reviews and staff meetingsAddress performance and behavioral issues promptly through coaching, feedback, and corrective action when necessaryMaintain visibility into UM inventory and turnaround times and ensure compliance with SLAs at corporate, client, and regulatory levels (CMS, NCQA, URAC)Ensure departmental adherence to UM processing guidelines, workflows, and policies across teamsReview UM trends, operational data, and case files to identify improvement opportunities and implement best practicesLead or support automation initiatives, system enhancements, and process redesign to reduce manual work and increase accuracyEnsure audit readiness and lead responses to internal and external audits, including corrective action plansServe as an operational lead and UM subject‑matter expert in cross‑departmental initiatives, issue resolution, process improvements, new implementations, and client onboardingPartner with analytics and reporting teams to enhance dashboards, scorecards, forecasting models, and operational reporting tools; provide leadership with actionable insightsLead or support enterprise initiatives such as cost‑containment programs, product expansions, RFP support, operational readiness for new markets, and strategic transformation effortsManage special projects as assigned, ensuring clear deliverables, timelines, and communication plansPerform other duties as assigned while maintaining professionalism, sound judgment, and adaptabilityWhat You BringEducation & ExperienceBachelor’s degree in Healthcare Administration, Business, or a related field (or equivalent combination of education and experience)Minimum 8 years of Utilization Management or healthcare operations experience (dental plan experience preferred)3–5 years of leadership experience managing UM teams, clinical operations, or high‑volume administrative operationsSkills & KnowledgeProven leadership, staff development, and team‑building abilitiesExtensive knowledge of UM processes, preauthorization/referral workflows, and related systemsExcellent organizational, analytical, and writing skillsStrong presentation skills with the ability to communicate effectively with executive audiencesProficiency with Microsoft Office tools (Word, Teams, Outlook, PowerPoint)Strong conflict management skillsAbility to work independently while driving strategic directionWhy This RoleThis is a highly visible leadership role with direct impact on operational performance, regulatory compliance, and service excellence. The Senior Manager, UM Operations plays a critical role in shaping how utilization management supports members, providers, and the organization.QualificationsLocationOur 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 OffersHappy, 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. CompensationIn the spirit of pay transparency, the base salary range for this position is $127,000 - $140,000 a year, 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 SpecificationsLiberty Dental Plan is an Equal Opportunity Employer / VETS / Disabled.No relocation assistance or sponsorship available at this time.