Compliance Auditor II - REMOTE
Health Services Advisory Group, Inc.

Columbus, Ohio

This job has expired.


Job Details

Are you passionate aboutimprovingthe quality of healthcare?
Are you ready toleverage your talentsto make healthcare better for everyone?
Do you want the opportunity togive backto your community?
Do you want to havefun at work?

Thenjointhe growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States!

Summary

Under direction, the Compliance Auditor provides ongoing project support of external quality review (EQR) activities related to regulatory audits, including compliance reviews; fraud, waste, and abuse audits; mental health parity evaluations, and program oversight audits. Responsible for reviewing assigned standards and completing all phases of assigned projects, including the desk review, site visit interviews (i.e., virtual or in-person), document tracking and assessment, synthesizing/analyzing compliance findings, and report production. Assists with external quality review organization (EQRO) projects including project initiation, client relations, and project planning.

Essential Competencies, Duties and Responsibilities

  • Assist in the coordination and management of EQR compliance reviews.
  • Preparation of project documentation related to key deliverables and support documentation of assigned projects
  • Conduct research and maintain knowledge of current federal and state Medicaid regulations, including state Medicaid contract terms and conditions.
  • Conduct literature searches and research on topics for use in conducting contracted EQRO activities.
  • Using statutes, regulations, and contracts, assist with the development of compliance review tools and materials.
  • Assist in coordinating, receipt, and tracking of the submission of review documents for desk reviews.
  • As part of a compliance review team, conduct desk reviews and site visits of Medicaid managed care health plans. In-person site visits will require travel.
  • Assist with the development, collection, analysis, and reporting of data.
  • Draft compliance review reports and other eternal quality review (EQR) reports.
  • Retrieve compliance review documents from the file transfer protocol (FTP) server as requested.
  • Project deadlines may necessitate occasional extended work hours.

    Additional Tasks

    • Attend various meetings and prepare meeting minutes.
    • Assist with preparing responses to request for proposals (RFPs).
    • Assist with preparing technical reports, as requested.
    • Assist with planning, conducting, and reporting focused studies, as requested.
    • Assist in coordination and scheduling of internal and external meetings as they relate to EQR activities.

      Compensation: 68,000 - 86,000 DOE

      Job Requirements:

      Education and/or Experience

      • Bachelor's degree in a healthcare-related field or an equivalent combination of education and experience.
      • Minimum three years of audit or project management/coordination experience in government, hospital, health plan, or other healthcare related field.
      • Experience in healthcare, including managed care.
      • Program Integrity experience, including health care compliance and fraud, waste, and abuse, preferred.
      • Health plan experience or state Medicaid program experience preferred.
      • Experience in written communication and reports.
      • Works well in a remote team environment and independently.

        Other Qualifications

        • Quality review and analytical experience, preferred.
        • Medicaid managed care experience preferred.
        • Experienced with MS Office and Windows software platforms.
        • Excellent oral and written communication skills.
        • Excellent interpersonal skills.
        • WORK ENVIRONMENT
          The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
          DISCLAIMER
          This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments).
          HSAG is an EEO Employer of Veterans protected under Section 4212.
          If you have special needs and require assistance completing our employmentapplication process, please feel free to contact us.
          EOE M/F/Vet/Disability

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