Description

You will support the enterprise's compliance program by conducting audit and monitoring activities, ensuring understanding of healthcare regulatory requirements, and helping assess business unit compliance. Help create risk-based audit plans, review regulations like HIPAA and Medicare, and communicate findings to business units.

Requirements

• Bachelor's Degree or equivalent work experience
• 3+ years in health care or related field
• 3+ years in health plan compliance
• 3+ years driving compliance with regulatory and accreditation audit/policy requirements
• 3+ years working with regulation translating into operational procedures

Responsibilities

• Create risk-based audit and monitoring plan
• Review healthcare regulations (HIPAA, Medicare, Medicaid, NCQA)
• Conduct assigned audits per departmental plan
• Test business operations for compliance
• Draft accurate audit reports and communicate findings