Compliance Specialist

Delta Dental Plan of Michigan, Inc.; Okemos (MI); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) savings plans

Tuition reimbursement

Job summary

Delta Dental Plan of Michigan, Inc. is hiring a Compliance Specialist in Okemos, MI. This hybrid position involves implementing the company's compliance program and collaborating with various departments to ensure adherence to regulations.

The ideal candidate will have a Bachelor's degree and three years of relevant experience, with a strong focus on analytical skills and compliance management. A comprehensive benefits package is offered.

Qualifications

• Three years of compliance or regulatory experience, preferably in the health or insurance industry.
• Compliance certification preferred.
• Strong ability to manage multiple projects.

Responsibilities

• Implements compliance program initiatives.
• Manages training materials and processes.
• Acts as a liaison for the compliance department.

Skills

Analytical skills

Interpersonal communication

Attention to detail

Organizational skills

Education

Bachelor’s degree in related field

Job description

Job Title

Compliance Specialist

Location

Okemos, MI – Hybrid Position

Job Summary

At Delta Dental of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we amplify this mission by investing in initiatives that build healthy, smart, vibrant communities. 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. At Delta Dental, we celebrate our All In culture. It’s a mindset, feeling and attitude we wrap around all that we do – from taking charge of our careers, to helping colleagues and lending a hand in the community.

Responsibilities

• Implements initiatives to raise awareness of Company’s Compliance Program including planning, developing and conducting education and training activities related to compliance.
• Responsible for the development of training materials, implementation of training calendar, monitoring and auditing employee training records.
• Monitors and evaluates documents to determine the relevance of regulatory updates that may affect member materials.
• Responsible for monitoring document revision processes, ensuring that changes are implemented from initial request through approval by internal and external parties and verifying the accuracy of final production.
• Provides consistent updates to management and relevant stakeholders on the status of document implementation and highlights any risks related to timely and accurate implementation.
• Manages and maintains a document repository of member and provider documents, to ensure that forms are consistent with company standards, and legal, contractual and regulatory requirements.
• Responsible for working with internal and external stakeholders to ensure work is prioritized and implemented by the required deadline.
• Acts as a liaison for the compliance department, collaborating with key departments to confirm policies and procedures are developed and implemented to ensure compliance with applicable contract provisions, rules and regulations, including the assessment, interpretation and drafting of policy, procedure or job aids.
• Advises organization and supports Compliance Officer in communicating regulatory changes and implementation of compliance strategies to meet them.
• Facilitates and manages coordination between compliance department and operations on new compliance efforts and initiatives.
• Plays a key role in the annual compliance risk assessment and collaborates to ensure proper auditing is conducted and management of identified risks is appropriate.
• Maintains and analyzes company’s monitored compliance efforts and identifies and assesses gaps.
• Coordinates various committees and task forces related to company’s compliance, including management of assignments.
• Facilitates and coordinates all aspects of any Medicare Advantage, Medicaid or Affordable Care Act audit, request, or inquiry by collecting, reviewing, analyzing and verifying all requested materials prior to submission, including any collaboration with the applicable operational subject matter expert that may be required as a result of the request.
• Performs other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

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.
• Compliance experience within the Medicare or Medicaid industry preferred.
• Compliance certification preferred.
• Capability to process substantial amounts of detailed information with a high degree of accuracy.
• Strong analytical skills and ability to efficiently manage multiple projects and effectively analyze data to develop alternative solutions.
• Excellent interpersonal, verbal, and written communication skills.
• Strong attention to detail, adaptability to shifting priorities and deadlines.
• Strong organizational skills and proficiency in handling competing demands.
• Ability to work independently and collaboratively within a fast‑paced team environment.

Benefits

Employees are offered a comprehensive benefits package that includes medical, dental and vision coverage, short‑ and long‑term disability, life insurance, 401(k) savings plans, flexible spending accounts, and tuition reimbursement or educational assistance. Employees are also eligible for annual incentive compensation based on annual business goals. Additionally, employees receive eight hours of paid volunteer time each year, access to an on‑staff health coach and personal trainer, plus many other perks.

Equal Employment Opportunity

The company will provide equal employment and advancement opportunity within the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance. Delta Dental of Michigan, Ohio, and Indiana is an Equal Opportunity Employer.