Manager, Grievance & Appeals

Liberty Dental Plan

Lead Grievance & Appeals operations at Liberty Dental Plan ensuring compliance and quality management. Oversee member grievances and appeals while guiding a high-performing team.

Posted 8/2/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $90,000 - $97,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing Grievance & Appeals processes while ensuring compliance with state and federal regulations. Proven ability to lead cross-functional teams, develop operational insights, and foster stakeholder relationships.

Highest-signal resume keywords

Grievance & Appeals ManagementRegulatory ComplianceCross-Functional Team LeadershipOperational Workflow DevelopmentStakeholder Engagement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Grievance ProcessingAppeals ManagementRegulatory FilingAudit Material CreationOperational Analysis

Soft Skills

Strong Verbal CommunicationStrong Written CommunicationOrganizational SkillsJudgment and Decision-MakingRelationship Building

Tools & Technologies

Microsoft Office

Industry Keywords

Health Plan PartnershipsQuality ManagementProvider DisputesEvidence of CoverageRegulatory Inquiries

About the role

Key responsibilities & impact

Lead and oversee all functions of the Grievance & Appeals department.
Ensure appeals, grievances, and provider disputes are processed accurately and within required regulatory and contractual timeframes.
Maintain compliance with applicable state and federal regulations and client-specific requirements.
Monitor regulatory changes and integrate new requirements into organizational grievance and appeals processes.
Identify operational issues, recommend solutions, and implement corrective actions to prevent recurrence.
Evaluate existing workflows and develop procedures to support new and expanding health plan partnerships.
Develop reports, analyses, and operational insights for internal committees, leadership teams, and key stakeholders.
Provide administrative and operational support for Quality Management activities and committees.
Assist with regulatory filings, including Evidence of Coverage (EOC) documents, benefit filings, service area expansions, and other plan-related submissions.
Respond to regulatory inquiries, requests, and comment letters.
Create audit materials, including universes and case file documentation, ensuring accuracy and completeness.
Serve as the primary presenter and representative for Liberty Dental Plan during internal and external Grievance & Appeals audits.
Foster positive, professional relationships with internal and external stakeholders.
Perform additional duties as assigned.

Requirements

What you’ll need

Minimum of 6 years of relevant professional experience.
Previous experience serving as a lead within an operational environment.
Experience managing cross-functional teams and initiatives.
Experience hiring, training, coaching, and managing employee performance.
Strong verbal and written communication skills.
Excellent presentation and stakeholder engagement skills.
Demonstrated ability to exercise sound judgment and make independent decisions.
Strong organizational skills with the ability to manage multiple priorities simultaneously.
Proficiency in Microsoft Office applications.
Ability to collaborate effectively across departments and build trusted working relationships.

Benefits

Comp & perks

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, 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.