Strategic Risk & CAP Analyst (Hybrid)

Delta Dental of Michigan; Okemos (MI); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Delta Dental of Michigan, Ohio, and Indiana seeks a Risk and Issue Management Analyst in Okemos, MI. This hybrid role focuses on due diligence for Problem Reports and CAPs to strengthen compliance and reduce corporate risk.

Responsibilities include root-cause analysis, cross-functional collaboration with Compliance, Operations, and IT, and tracking remediation efforts to ensure timely, effective results.

Qualifications

• Degree requirement: bachelor’s in business administration, health administration, or related field.
• Experience: at least three years auditing, quality monitoring, risk management, or operations.
• Regulatory familiarity: knowledge of regulatory frameworks related to the insurance industry (CMS, Medicare Advantage etc.).

Responsibilities

• Facilitates problem resolution from identification and impact assessment through root cause analysis, containment, remediation, and prevention.
• Analyzes root cause trends and recommends systemic improvements to reduce deficiencies, costs, and recovery time.
• Collaborates with Compliance, Operations, and IT to ensure Problem Reports and CAPs are realistic, measurable, and aligned with customer and business goals.
• Tracks and monitors Problem Reports and CAP progress and open corrective actions. Confirms completion and effectiveness, and recommends improvements to reduce risk, impact, and recurrence.
• Provides regular status updates to leadership and stakeholders to ensure internal and external due dates are met.
• Facilitates and educates teams on the Problem Reporting and CAP processes, compliance requirements, and preventive measures.
• Submits completed CAP and/or Problem Reports and supporting evidence to external clients in accordance with contractual obligations.
• Maintains Problem and CAP records, monitors actions, identifies trends, and reports results to management to validate audit readiness.

Education

Bachelor’s degree in business administration, health administration, or related field

Job description

Delta Dental of Michigan, Ohio, and Indiana seeks a Risk and Issue Management Analyst in Okemos, MI. This hybrid role focuses on due diligence for Problem Reports and CAPs to strengthen compliance and reduce corporate risk.

Responsibilities include root-cause analysis, cross-functional collaboration with Compliance, Operations, and IT, and tracking remediation efforts to ensure timely, effective results.