Tech Stack

Description

You will support the design, optimization, and implementation of processes to achieve organizational goals, including implementing regulatory requirements, compliance initiatives, and UM audits. This role involves coordinating projects, partnering with leadership and cross-functional teams, and supporting audit exams and corrective actions.

Requirements

• 1+ years in healthcare audits or accreditations supporting NCQA/regulatory compliance
• 1+ years in utilization management, healthcare operations, compliance, or related field
• 1+ years with Adobe Acrobat and Google Suite or Microsoft Office
• 1+ years experience collaborating with stakeholders to drive projects
• Bonus: experience with state audits, ACA marketplace, or Lean Six Sigma

Responsibilities

• Coordinate projects to support regulatory and compliance milestones
• Partner with leadership to implement regulations and support state filings
• Collaborate with cross-functional teams on action plans and process improvements
• Support audit exams (NCQA, MHPAEA, State)
• Identify risks and resolve compliance gaps through regulatory implementation and audits