Compliance Auditor - Non Clinical
5 days ago
Description
• Perform operational and compliance risk based audits for the health plan • Develop schedule and perform health plan audits and specialty care company (subcontractor) audits for either federal or state managed care programs • Evaluate processes and performance through audits for scalability, effectiveness, efficiency, and risk mitigation • Provide written audit documentation regarding state and/or federal managed care programs and process audit observations • Review and analyze responses to audit observations and findings and facilitate corrective action plans • Facilitate Health Plan and specialty care company (subcontractor) compliance through corrective action process • Identify, develop and implement corrective actions and training materials to improve program performance based on audit outcomes • Provide education and training to internal and external entities as needed on programs, compliance, and fraud, waste and abuse
Requirements
• Bachelor's degree in Business, Accounting, Finance, Healthcare or equivalent experience • 2+ years of compliance experience, preferably with State or Federal managed care programs
Benefits
• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules
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