- Assist in the analysis of the company's compliance with corporate governance policies and procedures (i.e. Corporate Compliance Program, Corporate Compliance Plan, Code of Conduct and Business Ethics Policy).
- Take a lead role training employees and overseeing Compliance course content where appropriate and necessary.
- Back-up Compliance Analyst on DDPA Association Compliance matters.
- Perform complex compliance research and regulatory analysis related to compliance with federal, state and local laws and regulations in order to monitor regulations and support business operations. This includes, but is not limited to, the Department of Labor ("DOL"), Health and Human Services ("HHS"), Centers for Medicare and Medicaid Services ("CMS"), various state departments of insurance, departments of revenue, secretary of state offices and local governmental entities.
- Analyze and interpret regulatory compliance requirements.
- Coordinate with internal departments and provide support for responding to external audits and reviews.
- Provide support on HIPAA privacy investigations and HIPAA privacy log maintenance as needed.
- Research various state insurance department and other state and local licensing requirements and assist in maintaining compliance with such requirements.
- Coordinate or oversee regulatory filings, submissions and reporting activities. This also requires maintaining working relationships with regulators and others to clarify and resolve issues.
- Monitor and review regulatory and legislative changes, preparing company's response to regulatory changes and following up with appropriate areas to ensure required changes are implemented.
- Review recent proposed activities by regulatory agencies to determine potential impact on company operations.
- Consult with business groups on strategic compliance initiatives and works to provide corporate compliance perspectives and develop strategy to reduce any potential compliance exposures.
- Provide recommendations to improve compliance controls, conduct analysis and create reports to help improve the compliance of the business.
- Develop and maintain positive working relationships with both internal and external customers.
- Administer, manage, and support a contract management system.
- Assist in monitoring and overseeing vendor compliance.
- Coordinate implementation of recommendations to improve compliance controls, conduct analysis and create reports to
- Develop familiarity with policies and procedures and be responsible for maintaining such policies and procedures in an
- Monitor compliance with the corporate records retention policy.
- Assist in monitoring strategic partner contract review and compliance.
- Develop, implement and coordinate compliance training and education programs.
- Collaborate and communicate with Operations in performing job responsibilities outlined above.
- Track compliance issues referred to the compliance department up to and including resolution.
- Other duties as assigned.
- Compliance professional preferred; or paralegal with experience in healthcare, insurance or related field. Experience
- Knowledge of insurance or healthcare laws and regulations and corporate governance laws and regulations.
- Excellent compliance and regulatory research skills and experience required.
- Excellent oral and written communication skills.
- Excellent organizational skills required and must be detail oriented.
- Effective analytical skills and problem solving capability.
- Prior contract management experience desired.
- Experience in policy and procedure management desired.
- Strong relationship management skills to manage internal and external relationships necessary to maintain an effective
- Strong leadership and project management skills. Must be able to work on multiple projects simultaneously.
- Must have the ability to work independently and in a team environment.
- Should have a flexible and adaptive work style, e.g., be able to deal effectively with ambiguity, change and adapt
- Advanced skills in Microsoft Office applications.
- Be of unquestionable integrity, ethical and moral character.
- General office working conditions, which may require sitting for extended periods of time.
- Infrequent overnight travel may be required.
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Compliance Specialist - St Louis, United States - Delta Dental of Missouri
Description
TITLE: Compliance Specialist
JOB CODE: E01305
GRADE LEVEL: 26
FLSA JOB STATUS: Exempt
DEPARTMENT: Corporate Compliance
REPORTS TO: Compliance Director & DDMO Compliance Officer
DATE WRITTEN: March 2024
General Description
The Compliance Specialist assists the Compliance Officer in the company's efforts to ensure compliance with applicable laws, regulations, and internal governance standards.
Responsibilities of this position include performing complex compliance research and regulatory analysis in order to assess and monitor compliance with laws and regulations and support business operations, covering three broad areas of compliance:
(1) General Corporate Compliance; (2) Government Regulatory Oversight; and (3) Customer and Contract Compliance.
Responsibilities
General Corporate and Association Compliance
Government Regulatory Oversight
Customer and Vendor Contract Compliance
Other Responsibilities
Education, Skills, Personal Attributes, and Experience Required
Work Conditions
Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities require the ability to focus distant and near objects clearly. While performing the duties of this job, the employee is regularly required to sit, talk and hear.
The employee is frequently required to use hands and arms to handle, feel and reach as well as operate a personal computer.
