Job Details

Compliance Consultant

Company name

Delta Dental of Iowa

Organization Type

In-House

Job Type

Legal Staff

Date Last Verified

Jun 27, 2020

Valid Through

Oct 10, 2020

Posted on

May 15, 2020

Years of Experience

3-5 yrs required

Location

Johnston, IA, United States

Employment Type

Full-time

Industry

Legal
Practice Area
Contract Law >> Contract Law
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Compliance Consultant
Duties: 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 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 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.

Qualification and Experience

Requirements: Bachelor’s degree in Business or related field, paralegal, JD Degree or equivalent work experience. 3-5 years’ experience in the insurance or financial services industry, preferred. 5+ years’ experience as a compliance consultant or supervisor, paralegal, internal auditor or federal or state examiner; or 2-3 years’ experience as an attorney. 5+ 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.

Company info

Hiring Coordinator
Delta Dental of Iowa
2401 SE Tones Drive
Suite 13
Ankeny, IA 50021

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