Compliance Specialist

Job Summary

At Delta Dental of Michigan, Ohio, and Indiana, we work to improve oral health through benefit plans, advocacy, and community support. We are one of the largest dental plan administrators in the country, and are part of the Delta Dental Plans Association, which operates two of the largest dental networks in the nation. As a Compliance Specialist, you will support the day-to-day operations and management of the Compliance Program.

Primary Job Responsibilities

• Implements initiatives to raise awareness of Company’s Compliance Program including planning, developing and conducting education and training activities related to compliance.
• Develops and implements training materials, creates a training calendar, monitors and audits employee training records.
• Maintains a document repository of member and provider documents, ensuring they are consistent with company standards, legal, contractual, and regulatory requirements.
• Manages and coordinates various committees and task forces related to company’s compliance.
• Facilitates and coordinates all aspects of any Medicare Advantage, Medicaid, or Affordable Care Act audit, including collecting, reviewing, analyzing, and verifying all requested materials.
• Maintains and analyzes company’s monitored compliance efforts and identifies and assesses gaps.
• Coordinates with the Compliance Officer to communicate regulatory changes and implement compliance strategies.
• Assists in the annual compliance risk assessment and ensures proper auditing and management of identified risks.

Minimum Requirements

• Bachelor’s degree in business administration, health administration, public health/public policy, or a related field.
• Three years of compliance or regulatory experience, preferably in the health or insurance industry, or five years of experience related to auditing, quality monitoring, risk management, or operations.
• A compliance certification is preferred.

Position Requirements

• The ability to process substantial amounts of detailed information with a high degree of accuracy.
• Strong analytical skills and the ability to efficiently manage multiple projects.
• Excellent interpersonal, verbal, and written communication skills.
• A strong attention to detail and adaptability to shifting priorities and deadlines.
• Strong organizational skills and proficiency in handling competing demands.
• The ability to work independently and collaboratively within a fast-paced team environment.