Regulatory & Group Audit Analyst

JOB DESCRIPTION
This position is responsible for the overall success of assigned external audits initiated by state/federal regulatory agencies, the Delta Dental Plans Association, and group clients (Medicare/Medicaid/Medical Partners and Commercial groups). The role partners with key stakeholders to perform verification of external audit findings and validation/closure of external audit corrective action plans in an effort to anticipate gaps in regulatory or contractual compliance, fines, and sanctions. In addition to being the organization's core advocate throughout the external audit process, other responsibilities include collaborating with internal business partners to ensure responses to external audit requests, inquiries, and findings adequately and comprehensively meet expectations.
RESPONSIBILITIES

• Serves as the principal point of contact and advocate for the Company for all external audits initiated by state or federal regulatory agencies and group clients.
• Leads external audit kick-off and closing meetings with regulatory examiners and group client auditors and ensures the right participants are engaged to help drive the appropriate outcomes.
• Analyzes applicable regulatory mandates and group contract obligations in relation to external audit information requests, collaborates with Legal Affairs and Policy subject matter experts on interpretation and requirements, and prepares for timely hand-off to Regulatory Adherence.
• Strategizes, advises, and proposes options to internal stakeholders on the development of responses to external audit findings and manages the external submission (ensuring requirements are met) to the regulatory examiner or group client auditor.
• Analyzes proposed external audit findings received from regulatory examiners and group client auditors against the external audit scope, and formalizes communication to the Regulatory Adherence Team for operational analysis and validation.
• Engages appropriate Legal Affairs and Policy Division resources regarding potential legal and compliance (regulatory and contractual) issues identified or anticipated in external audits.
• Assesses trends in external audit findings and alerts internal stakeholders of potential enforcement and/or liability issues.
• Manages the communication and advocacy of all external audit finding dispute/rebuttal with regulatory examiners and group client auditors.
• Ensures quality documentation for external audits are adequately maintained in the GRC system and that the record is closed upon completion.

QUALIFICATIONS

• 2+ w/Bachelor's degree
• Excellent communication skills with a customer-centric approach when interacting with stakeholders (internal and external)
• Detail-oriented with strong analytical and problem-solving skills
• Understands process flows and can identify roadblocks and devise solutions to improve processes
• Strong organizational and time management skills, including the ability to prioritize and manage duties to meet goals and deadlines
• Aptitude to learn and develop proficiencies with new concepts, legal requirements, processes, and technology
• Effectively able to adapt to change and be comfortable handling risk and uncertainty
• Ability to maintain confidentiality when exposed to sensitive information
• Knowledge of Microsoft Office programs, i.e. Word, Excel, Outlook etc.
• Strong working knowledge of health insurance (including Medicare/Medicaid) terminology, processing concepts, policies, guidelines, and systems
• Knowledge of governance, risk, and compliance (GRC) tools

Base Pay Information
The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. $55,000 - $116,900
ADDITIONAL INFORMATION
Rewards to make you smile! We don't just want to make our customers happy - we want to give our employees a reason to smile, too. Delta Dental's comprehensive benefits package includes:

• Generous paid time off plus 12 holidays and your birthday off!
• Low-cost premium medical insurance options
• 100% paid dental and vision insurance
• Generous 401(k) matching and flat contribution
• Social responsibility and volunteer opportunities, including 16 paid volunteer hours annually
• Employee LiveWell program, focusing on overall employee well-being
• Fertility and diabetes benefits
• Employee discount program: AT&T/Verizon, entertainment, travel, and more!
• Culture of learning: career development and tuition reimbursement
• Career growth: we love promoting from within

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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ABOUT THE TEAM
At Delta Dental, our success is only as strong as the people who execute it! We take enormous pride in being the nation's most recognized and widely-used provider of dental insurance - and we've come this far by living our core values of innovation, excellence, service and trust. Our vision is to motivate and empower every employee so that we're all inspired to take exceptional care of our customers, providers and ourselves. We believe in integrity, accountability, collaboration, and giving every employee equitable opportunity for their voice to be heard and development to be fostered.
If you're excited about the prospect of transforming the future of health care and growing in your career, join our smile revolution!
To see some of the smiling faces behind Delta Dental and to learn more about what our values and culture look like in action, connect with us on social media: Delta Dental Ins. on Facebook and Instagram, #LifeatDDins on Facebook and Instagram, Delta Dental Ins. on Twitter and Delta Dental Ins. on LinkedIn.
We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation's largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country.
Delta Dental is an equal opportunity employer. We are committed to building and maintaining a diverse and inclusive workplace for all employees. Applicants will not be discriminated against because of race, color, religion, creed, national origin, ancestry, citizenship status, sex (including pregnancy), sexual orientation, gender or identity expression, age, disability, marital status, medical status, veteran status or any other status protected under federal, state, or local law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico or other US Territories at this time.
Proof of eligibility to work in the United States must be provided if selected for hire.
*Delta Dental includes: Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, and Delta Dental of New York
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