At Delta Dental, our strategy is only as strong as the people who execute it! We are hiring individuals that are not just right for today but also for our future. We have built a foundation of high-trust by treating all people with dignity, making and keeping commitments, and consistently striving to do the right thing. Our leaders optimistically share future possibilities to inspire and motivate others toward their full potential. We expect our employees to find ways to embrace positive change, be curious and challenge the status quo, and provide solutions to unmet problems. Joining Delta Dental means joining a culture focused on fostering development, building genuine connections, recognizing each other’s strengths and sharing in successes.
The Regulatory Exams & Group Audits Manager leads a team with a subject matter expertise of legislative, regulatory, and contractual issues affecting commercial and Medicare health plans in 50 states. The incumbent is responsible for managing activities specific to maintaining positive relationships with group client auditors, all regulatory bodies with oversight of the company, and supporting strategic initiatives. As a subject matter expert, the incumbent maintains knowledge of laws, regulations, and company strategies to assess impact and consult with functional business areas. The incumbent may also conduct complex assessments, document findings, and ensure corrective actions are developed.

How you will make an impact:

  • Leads a team of regulatory exam and group audit analysts, including screening and selection, development, performance management, and employee relations functions.
  • Leads a team of regulatory exam and group audit analysts, including screening and selection, development, performance management, and employee relations functions.
  • Develops audit/exam program strategies and execute through a team, including: communicating changes in regulatory and group client requirements, responding to regulatory and group client inquiries, providing feedback on operational issues that have regulatory impact, and actively working with cross-functional teams on documentation required to meet strict timelines.
  • Ensures company policies & procedures are adhered to and trainings related to regulatory compliance and ethics are enforced in the team.
  • Participates in risk management reviews and provide guidance to team on risk management processes to maintain compliance with current standards.
  • In collaboration with the regulatory compliance team, perform in-depth legal research and analysis of enacted laws and regulations applicable to the insurance industry.
  • Through and with a team of analysts, anticipate regulatory exam/group audit obstacles and emerging issues throughout the regulatory exam/group audit lifecycle; develop processes and solutions in collaboration with members of the regulatory compliance teams to address issues.
  • Maintains data on continuous performance and quality improvement activities, including regular reporting on the status of performance and quality improvement efforts and impacts through the tracking of KPIs, KVIs, and other key metrics.
  • Represents the function with key business stakeholders, working to enable business outcomes with a compliance orientation.
  • Builds relationships with external partners, such as regulators, and leverage those relationships to ensure we are meeting business and compliance outcomes.
  • Manages vendor relationships for any outsourced work.
  • This list is not all-inclusive and you are expected to perform other duties as requested or assigned.

What we look for:

  • 8+ years w/Bachelor’s degree; 1+ years supervisory/management.
  • Strong health insurance regulation (including Medicare/Medicaid) experience and managing a team is required.
  • Prior experience in executing regulatory compliance investigations and/or internal audits is preferred.
  • General knowledge of project management preferred.
  • Strong leadership skills with the ability to effectively manage up, down, and across an organization.
  • Ability to manage and organize others in fast-paced environments with multiple deadlines and deliverables.
  • Strong verbal and written communication skills.
  • Excellent interpersonal skills with the ability to build strong partnerships with external and internal stakeholders.
  • Demonstrated creative problem solving and decision-making skills.
  • Knowledge of regulatory and legal environments as related to the health insurance industry.
  • Proficiency in GRC tools as well as Microsoft Office Suite, including Word, Excel, Outlook, and Teams.

Benefits and perks:

  • 12 days starting vacation, 12 holidays, 9 sick days 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
#LI-JB1
At Delta Dental we:
Promote accountability, integrity and collaboration: Our employees are collaborative, self-aware, and ethical. It is our expectation to do the right thing and follow through on commitments. Foster professional development: Our employees take ownership of developing themselves and others through coaching, mentoring and providing/being open to constructive feedback and identifying learning opportunities. Value customers and cultivate positive experiences: Our employees take time to build rapport with customers, while anticipating and exceeding their needs to ensure positive outcomes.
If you think this sounds like you, let’s chat. We would love to tell you more!
To see some of the smiling faces behind Delta Dental and to learn more about what our values and culture look like in action, connect with us on social media: @lifeatddins on Facebook and Instagram, @deltadentalins on Twitter, and Delta Dental Ins. on LinkedIn. ABOUT Delta Dental Delta Dental covers more Americans than any other dental benefits provider. Our vision is to motivate and empower every employee so we’re all inspired to take exceptional care of our customers, providers and each other. Our Enterprise Strategy focuses on pillars of Growth and Diversification, supported by the platforms of Culture and People, Process and Technology. Our employees take pride working for a purpose-driven organization and live our values of Trust, Service, Excellence and Innovation. We are part of the Delta Dental Plans Association, a network of companies that provides dental coverage to 74 million people in the U.S. Delta Dental of California, Delta Dental of New York, Inc., Delta Dental of Pennsylvania and Delta Dental Insurance Company, together with our affiliate companies, form one of the nation’s largest dental benefits delivery systems, covering 33 million enrollees. All of our companies are members, or affiliates of members, of the Delta Dental Plans Association, a network of 39 Delta Dental companies throughout the country. Delta Dental provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other classification protected by federal or state law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, North Dakota, Nebraska, Hawaii, Oklahoma, Vermont, Maine, West Virginia, New Hampshire, Wyoming, Puerto Rico or other US Territories at this time.
Proof of eligibility to work in the United States must be provided if selected for hire.
Delta Dental* has enacted a COVID-19 vaccination policy to protect all employees and the communities we serve due to the ongoing impacts of the COVID-19 pandemic. Accordingly, we require all employees to be fully vaccinated for COVID-19. Are you able to comply with our policy of being fully vaccinated by your start date if an offer is made or have a medical or sincerely held religious exemption for receiving a COVID-19 vaccine? Failure to comply with our policy and submit proof of compliance or receive approval for a valid medical or sincerely held religious belief exemption prior to your start date will nullify any offer of employment extended to you.
  • Delta Dental includes: Delta Dental of California, Delta Dental Insurance Company, Delta Dental of Pennsylvania, and Delta Dental of New York
  • Company:
    Delta Dental Ins.
  • Job Type:
  • Posting Date:
    13th May 2022
  • Valid through:
    13th Jun 2022
  • Location:
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