Associate Director, Quality and Compliance

Role Overview

• Provides operational guidance in the effective delivery of services to clients, members, and stakeholders
• Collaborates on service delivery, corporate and division strategic priorities and compliance with implementation of all regulatory requirements
• Handles contractual and regulatory quality and compliance for California government program clients
• Serves as the compliance subject matter expert (SME) to the operational leads in implementation of contractually and regulatorily compliant processes
• Administers an organizational quality management system and monitors progress against strategic and contractual quality-related goals
• Monitors, researches federal and state regulations and proposed regulations to identify applicability for Company and works with Government Relations and Legal to ensure appropriate application of laws and regulations
• Develops training programs to ensure DentaQuest is meeting its legal and contractual obligations
• Coordinates and communicates to internal departments and external clients and vendors, where appropriate, all compliance activities and programs
• Maintains up-to-date knowledge of developments in all legislative and regulatory implications for DentaQuest California
• Oversees the operational aspects of California compliance and Quality, working closely with leadership in operational areas to provide audit and monitoring oversight
• Assists operational departments with review of policies and procedures designed to ensure compliance with contract obligations and other applicable requirements
• Develops policies and procedures to ensure DentaQuest’s Operations in is compliance

Requirements

• Five years’ experience in government programs product management, regulatory affairs, operations or other similar healthcare related government programs function preferably in health care/managed care environment
• Up-to-date knowledge of state and federal laws and regulations, including Medicare/Medicare Advantage and Medicaid requirements
• Proven ability to influence cross-functional teams without formal authority, including skills in collaborating and influencing others
• Excellent communication skills (verbal, written and presentation) required for formal reports and updates
• Ability to read statutes and regulations and interpret them in order to identify compliance needs/risks, etc.
• Attend additional training as requested/deemed necessary
• California Regulatory knowledge, preferred
• Reasoning skills to interpret, predict and improve process and performance creations and analytic skills of Charts and Graphs
• Attention to detail
• Strong verbal and written communication skills
• Strong knowledge of Microsoft Office Systems

Benefits

• generous vacation and sick time
• market-leading paid family, parental and adoption leave
• medical coverage
• company paid life and AD&D insurance
• disability programs
• partially paid sabbatical program
• 401(k) employer match
• stock purchase options
• employer-funded retirement account