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Compliance and Privacy Specialist

Johnston, IA (http://maps.google.com/maps?q=9000+Northpark+Drive+Johnston+IA+USA+50131)

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Job Type

Full-time

Description

Come Smile with Us!

Delta Dental of Iowa is seeking a detail-oriented and proactiveCompliance and Privacy Specialistto execute daily operations of our Compliance Program. In this role, you will help ensure regulatory compliance by maintaining audit-ready documentation, tracking issues, translating complex healthcare regulations into actionable guidance, and collaborating across departments to manage risk and uphold ethical standards. Ideal candidates will have a strong understanding of HIPAA, ERISA, and CMS requirements, along with a passion for promoting transparency and accountability in a mission-driven environment. This hybrid role collaborates with the Compliance & Legal Consultant and reports to the Compliance & Quality Assurance Director. This position is located in Johnston, Iowa.

Learn whyKwesi (https://youtu.be/0EWUrwyCRjQ?si=uUeNAr6gi-OWef5A) enjoys working on the Compliance team.

Why Delta Dental of Iowa?

For your smile. For your health. For your community.

At Delta Dental of Iowa, we’re more than just a dental and vision insurance company. Improving health and wellness is at the center of everything we do. As a not-for-profit, we aim to build stronger communities by investing in actions that promote and improve health. Delta Dental of Iowa invests 40% of our dollars directly back into the communities we serve.

Come see why we are passionate about "Bringing Smiles" to our customers. Our team enjoys competitive pay and benefits, an awesome "One Team" approach, and a company culture that fosters "Exceptional Quality Service" and "Leadership at All Levels." Together, we can make a difference – not only in Iowa but across the country.

Essential Functions and Principal Accountabilities:

+ Support the execution and daily operations of the Compliance Program. Track progress on the Compliance Work Plan and upholds organized, verifiable records to support audit readiness.

+ Analyze and interpret federal and state regulations (e.g., HIPAA, ERISA, Affordable Care Act, CMS), monitor emerging regulatory trends, and translate requirements into actionable compliance strategies that align with business operations.

+ Research and respond to compliance-related questions, analyze findings to identify root causes, and translate insights into clear, actionable summaries. Track issues and corrective action plans from initiation through resolution.

+ Coordinate third-party reviews and audits and act as a liaison with auditors and examiners (Delta Dental Plan Association (DDPA), Iowa Insurance Division, CMS, SOC) including tracking issues, managing correction actions and ensuring issues are resolved timely and adequately.

+ Conduct ad-hoc reviews and monitor adherence to internal policies, regulatory requirements, and contractual obligations.

+ Assist in the development and maintenance of compliance policies and procedures.

+ Develop, revise, and deliver compliance training materials that are relevant, engaging, and aligned with regulatory and contractual requirements.

+ Analyze new or updated DDPA standards, monitor compliance, and report findings to support timely implementation across the business.

+ Support the maintenance of business continuity and crisis communication plans, ensuring alignment with compliance and operational standards.

+ Investigate and oversee compliance related functions including appeals, complaints, and privacy incidents.

+ Collaborate with business to understand daily activity and identify potential risks or compliance concerns.?

+ Support the annual liability insurance renewal process.

+ Review marketing materials and documents for regulatory and contractual compliance.

+ Prepare and manage dashboards, reports, and tracking tools to monitor and track compliance activities, emerging risks, and process improvements.

+ Maintain confidentiality and navigate sensitive matters related to organization, employee and senior leadership situations.

+ Perform other duties as assigned.

Requirements

Required

+ Bachelor’s degree in business, healthcare, or related area of study, or equivalent combination of education and/or relevant work experience.

+ Minimum of 2 years’ experience in healthcare compliance, privacy, or regulatory experience; or one year practicing law.

+ Knowledge of federal and state healthcare regulations, including HIPAA, HITECH, ERISA, the False Claims Act, the Anti-Kickback Statute, Medicare Advantage, Medicaid, and CMS requirements. Ability to research, understand and apply regulatory requirements to support practical compliance solutions under guidance.

+ Self-directed and adaptable, with sound judgment in routine regulatory matters and a willingness to seek input on complex issues.

+ Demonstrated organizational, analytical and time management skills, with exposure to project coordination or process improvement.

+ Clear and professional communicator, able to collaborate effectively across teams and support external communications.

+ Detail-oriented with the ability to manage multiple tasks and meet deadlines.

+ Proficient in Microsoft Word and Excel.

+ Successful candidate must pass a post-offer background check and drug screen testing as a condition of employment.

Preferred

+ 3+ years of experience interpreting healthcare regulations and converting them into compliant policies, procedures, and training.

Delta Dental of Iowa is an Equal Opportunity Employer that does not discriminate on the basis of race, sex, national origin, religion, age, disability and any other characteristic protected by applicable law. It is also the policy of Delta Dental of Iowa to take affirmative action to employ and to advance in employment, all persons regardless of their status as individuals with disabilities or protected veterans, and to base all employment decisions only on valid job requirements.