Regulatory Compliance Manager, SIU & Data Analytics (Hybrid)

rhsc; Nashville (TN); Hybrid; USD 110,000 - 140,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana seeks a Regulatory Compliance Manager in Nashville, TN. This hybrid role oversees the Government Programs SIU team, including audits, data research and investigations to meet regulatory, contractual, and corporate goals.

You will lead staff, develop policies, coordinate with law enforcement as needed, and serve as SME for data research, claims processing and reporting related to provider agreements and government contracts.

Qualifications

• Bachelor's degree required; seven years of auditing/analytical experience in insurance preferred.
• Three years of leadership experience required.
• Experience with claims processing software or provider contract analysis is preferred.

Responsibilities

• Plans, organizes and oversees SIU team administrative and technical functions to meet goals.
• Manages SIU processes for Government Programs as assigned.
• Interviews, hires, trains, mentors and evaluates staff to ensure objectives are met.
• Develops and enforces policies for audits and investigations; prepares departmental reports.
• Maintains relationships with internal and external partners to support SIU activities.
• Oversees claims processing and ensures timely, accurate handling under contracts.

Skills

Leadership

Auditing

Data analysis

Education

Bachelor's degree in statistics, criminal justice, finance, healthcare management or related field

Job description

Delta Dental of Michigan, Ohio, and Indiana seeks a Regulatory Compliance Manager in Nashville, TN. This hybrid role oversees the Government Programs SIU team, including audits, data research and investigations to meet regulatory, contractual, and corporate goals.

You will lead staff, develop policies, coordinate with law enforcement as needed, and serve as SME for data research, claims processing and reporting related to provider agreements and government contracts.