Are you a detail-oriented compliance professional with strong problem solving skills looking for a new opportunity? Delta Dental of Iowa is seeking a Compliance Consultant to provide reasonable assurance of compliance with applicable federal and state laws and governance standards, Delta Dental Plan Association (“DDPA”) and DeltaUSA membership standards, policies and procedures, and Delta Dental of Iowa (“DDIA”) compliance -related policies and procedures. This is accomplished by providing effective and efficient oversight of the related operational functions. You will assist the organization in identifying, assessing and mitigating compliance and operational risks, opportunities and potential gaps. You will also provide compliance-related training to employees and serve as a key resource and business partner to implement required policies, procedures and practices.
Delta Dental of Iowa provides dental and vision insurance to more than 1 million Iowans. As a not-for-profit insurance company, our mission is to improve the health and smiles of the people we serve. We give back to Iowa communities by supporting and funding health and wellness initiatives that make a measurable difference in the overall health of underserved Iowans. Come see why we are passionate about "Bringing Smiles" to our customers. Our team enjoys competitive pay and benefits, an awesome "One Team" approach, and a company culture that fosters "Exceptional Quality Service" and "Leadership at All Levels." Love where you work!
Essential Functions and Principal Accountabilities:
- Serve as a key resource to business areas regarding regulations and act as a liaison between the business units and legal counsel regarding legal and regulatory questions or interpretations.
- Research and respond to compliance-related questions providing guidance in an effective, efficient, and timely manner.
- Interpret, analyze and determine the impacts of new or changed regulations on policies, procedures and processes. Summarize and report potential impacts to business areas in a timely manner.
- Lead change management activities needed to communicate and implement new or changed regulatory requirements into processes.
- Partner with the DDIA and/or DDPA Government Relations Teams to monitor, review and respond to new and/or changed federal and state regulatory requirements impacting the business.
- Review and revise corporate governance and risk management-related policies and procedures according to schedule. Conduct applicable reviews and report compliance with such policies, e.g. Conflict of Interest Review.
- Provide oversight for compliance-related functions including but not limited to: complaints, appeals, HICS monitoring, and incident reporting and response procedures.
- Partner with functional areas to determine the root cause of issues and help develop corrective action plans to address the same.
- Create reporting formats and report audit/review findings in a timely and accurate manner.
- Follow-up on all open issues to ensure the action plans are implemented in the most timely and effective manner. Document and report the status on a regular basis.
- Foster mutually beneficial relationships with all functional areas and levels of management by continuously acting as a partner and resource to them.
- Lead ongoing development and/or facilitation of compliance-related training for employees, temporary staff, and independent contractors, i.e. Confidential Information, Business Continuity Planning, Incident Reporting & Response, Complaints, HIPAA Privacy and Security Standards.
- Review contracts and agreements and partner with relationship owners to negotiate terms, as needed.
- Review marketing collateral, insurance forms and documents for regulatory compliance.
- Communicate, monitor and report compliance with DDPA and DeltaUSA Membership Standards and Policies and Procedures.
- Oversee and coordinate third-party audits and exams and act as a liaison between the company and the auditors and examiners.
- Perform other duties as assigned.
- Bachelor’s degree in Business or related field, paralegal, Juris Doctorate or equivalent work experience.
- Three to five years’ experience in the insurance or financial services industry, preferred.
- Five or more years’ experience as a compliance consultant or supervisor, paralegal, internal auditor or federal or state examiner; or 2-3 years’ experience as an attorney.
- Five or more years’ experience analyzing and interpreting federal and state regulations and guidance and transferring it into processes, policies, procedures and training materials to comply.
- In-depth understanding or working knowledge of the laws and regulations applicable to the dental/health insurance industry such as ERISA, HIPAA, Affordable Care Act (“ACA”), and/or Medicaid and Medicare Managed Care-related regulations, is preferred.
- Self-directed individual with ability to work independently and as part of a team to achieve goals and objectives.
- Detail and results-oriented individual with demonstrated abilities to prioritize, delegate, organize and function effectively with multiple concurrent assignments/projects.
- Strong problem solving skills
- Strong, clear and concise writing and presentation skills.
- Excellent interpersonal, analytical, change management and communication skills.
- Proficient using Microsoft Office applications specifically Word, Excel, Visio, and Power-Point.
- Knowledge of Delta Dental’s policies, procedures, practices and systems is a plus.
Delta Dental of Iowa is an Affirmative Action and Equal Opportunity Employer committed to providing equal employment opportunity for all persons without unlawful regard of race, color, religion, sex, sexual orientation, gender identity, age, national origin, individuals with disabilities, protected veteran status, or any other legally protected basis.
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