Regulatory & Group Exam Analyst

Job description

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. - Serves as the principal point of contact and advocate for the Company for 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...