Contract Implementation & Compliance Spec II
Location: Milwaukee, Wisconsin US
Job Number: 1336
The Contract Implementation & Compliance Specialist II is responsible for the end-to-end servicing of state and health plan contract work, from generating the initial client contract draft, coordinating approvals and execution, tracking implementation, and preparing submission of all client audits of those contracts. The Specialist will also focus on the Company's submission of product and related filings, including the review of policy documents and will be primary contact with state regulators.
Primary Job Responsibilities
Contract Implementation & Compliance:
- Intake client audit requests, including audit tools, from clients and disseminate deliverable requirements with appropriate background and context to internal subject matter experts
- Review and ensure complete and accurate audit responses prior to client submission
- Host onsite and desktop audits with clients, including the coordination of SME interviews with the clients
- Audit contract compliance and metric requirements
- Cultivate and maintain professional relationships with DentaQuest client
- Prepare, review, and revise product related filings for the Company's insurance products. This includes, but not limited to, policy related documents, rate documentation, and provider agreements.
- Gathers, reviews, and submits documentation related to Company's product filings directly to various Departments' of Insurance, using SERFF and other filing methodologies.
- Act as primary contact communicating regularly and frequently with regulators across the country with respect to filings; facilitating all correspondence between the Company and regulators timely.
- Collaborate cross-departmentally on product strategy, timeliness of filings, and various filing processes; identifying, recommending, and implementing filing efficiencies along the way.
- Update Manager regularly on status of audit activities.
- Organize workflow throughout various departments to create improvements and efficiencies with audits, contracts and product filings.
- Perform miscellaneous tasks and assist with projects as assigned by the Manager.
- Always represent DentaQuest in a professional manner.
- 5+ years of related business experience
- Ability to effectively work with clients, as well as internal departments as required to accomplish each task.
- Strong time management, organizational, and prioritization skills.
- Ability to manage multiple tasks.
- Self-motived, and ability to work with little supervision and make independent decisions.
- Extensive knowledge of general computer software required (Excel, MS Word, SERFF, Compliance 360 a plus).
- Excellent verbal and written communication skills required.
- Ability to work overtime as needed or required.
- Attends additional training as requested/deemed necessary
- Paralegal or other law firm or in-house legal experience
- Incumbent must be able to communicate effectively.
- Requires overall light physical effort (up to 25lbs.)
- Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal compute).
- Ability to travel or move about within and outside serviced facilities required.
- Incumbent works primarily in either a private or shared office environment.
Webelieve that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system - from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.
Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.
To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and deliveringmeasurableoutcomes for the people we serve.
The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.
Job Number: 4188
Community / Marketing Title: Contract Implementation & Compliance Spec II
Location_formattedLocationLong: Milwaukee, Wisconsin US