This position is responsible for the overall success of assigned external audits initiated by state/federal regulatory agencies, the Delta Dental Plans Association, and group clients (Medicare/Medicaid/Medical Partners and Commercial groups). The role partners with key stakeholders to perform verification of external audit findings and validation/closure of external audit corrective action plans in an effort to anticipate gaps in regulatory or contractual compliance, fines, and sanctions. In addition to being the organization's core advocate throughout the external audit process, other responsibilities include collaborating with internal business partners to ensure responses to external audit requests, inquiries, and findings adequately and comprehensively meet expectations.

　　Responsibilities:

　　Serves as the principal point of contact and advocate for the Company for all external audits initiated by state or federal regulatory agencies and group clients.Leads external audit kick-off and closing meetings with regulatory examiners and group client auditors and ensures the right participants are engaged to help drive the appropriate outcomes.Analyzes applicable regulatory mandates and group contract obligations in relation to external audit information requests, collaborates with Legal Affairs and Policy subject matter experts on interpretation and requirements, and prepares for timely hand-off to Regulatory Adherence.Strategizes, advises, and proposes options to internal stakeholders on the development of responses to external audit findings and manages the external submission (ensuring requirements are met) to the regulatory examiner or group client auditor.Analyzes proposed external audit findings received from regulatory examiners and group client auditors against the external audit scope, and formalizes communication to the Regulatory Adherence Team for operational analysis and validation.Engages appropriate Legal Affairs and Policy Division resources regarding potential legal and compliance (regulatory and contractual) issues identified or anticipated in external audits.Assesses trends in external audit findings and alerts internal stakeholders of potential enforcement and/or liability issues.Manages the communication and advocacy of all external audit finding dispute/rebuttal with regulatory examiners and group client auditors.Ensures quality documentation for external audits are adequately maintained in the GRC system and that the record is closed upon completion.

　　Qualifications:

　　2+ w/Bachelor's degreeExcellent communication skills with a customer-centric approach when interacting with stakeholders (internal and external)Detail-oriented with strong analytical and problem-solving skillsUnderstands process flows and can identify roadblocks and devise solutions to improve processesStrong organizational and time management skills, including the ability to prioritize and manage duties to meet goals and deadlinesAptitude to learn and develop proficiencies with new concepts, legal requirements, processes, and technologyEffectively able to adapt to change and be comfortable handling risk and uncertaintyAbility to maintain confidentiality when exposed to sensitive informationKnowledge of Microsoft Office programs, i.e. Word, Excel, Outlook etc.Strong working knowledge of health insurance (including Medicare/Medicaid) terminology, processing concepts, policies, guidelines, and systemsKnowledge of governance, risk, and compliance (GRC) tools

　　Base Pay Information

　　The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. $55,000 - $116,900

　　Additional Information:

　　Rewards to make you smile! We don't just want to make our customers happy - we want to give our employees a reason to smile, too. Delta Dental's comprehensive benefits package includes: Generous paid time off plus 12 holidays and your birthday off! Low-cost premium medical insurance options 100% paid dental and vision insurance Generous 401(k) matching and flat contribution Social responsibility and volunteer opportunities, including 16 paid volunteer hours annually Employee LiveWell program, focusing on overall employee well-being Fertility and diabetes benefits Employee discount program: AT&T/Verizon, entertainment, travel, and more! Culture of learning: career development and tuition reimbursement Career growth: we love promoting from within

　　Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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