19 days old
2017-12-292018-01-28

Controls Consultant

MetLife
Irvine, CA
**Job Location:** Irvine, CA







**Job Summary:** This position will be responsible for all quality assurance activities as required for all dental and vision HMO insurance offerings. The role will support Dental Product Management on other state and federal statutory and regulatory requirements and focus on overall compliance related activities.







**Functional Responsibilities:**







+ Manages and oversees all quality assurance reporting and activities for the dental and vision HMO product.



+ Completion of all utilization and PQI reporting and meetings as well as Dental Peer and PQI Minutes.



+ Supervises the completion of and ensures that all regulatory filings are timely completed.



+ Supervises the facility audit program and routinely interacts with the Dental Director and Dental Consultants.



+ Regularly partners with the grievance and network development teams to monitor any quality concerns and collaborates to initiate corrective action, as needed.



+ Analyzes utilization of services to determine where any potential quality issues may be present, or when discussions with the fraud investigation unit are necessary.



+ Assists in gathering required information for regulatory audit responses and examinations.



+ Collaborates with external partners on industry wide efforts to share facility audit data.







**Essential Business Experience and Technical Skills:**







Required:







+ Bachelors degree



+ 3+ yrs relevant business experience within dental insurance industry



+ Advanced skills in Microsoft Excel and Word



+ Strong communication and speaking skills







**Business Category**







_U.S. Business_31294_







**Number of Openings**







_1_







**At MetLife, were leading the global transformation of an industry weve long defined. United in purpose, diverse in perspective, were dedicated to making a difference in the lives of our customers.**

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Controls Consultant

MetLife
Irvine, CA

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MetLife
Irvine, CA
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