Audit and Compliance Analyst *Hybrid*

About the position reputed company Health Plan is calling an Audit and Compliance Analyst who will handle various reputed company of program compliance, policy development, auditing, monitoring, and report development reputed company the Health Care Services teams including Care Management and Utilization Management. The role involves working as a reputed company for external delegated entities to reputed company operational support in reputed company to auditing and monitoring delegated functions. The analyst will collaborate with the Regulatory Compliance & Government Affairs department (RCGA) to evaluate state and federal regulations as they pertain to Health Care Services and the various lines of business. Additionally, the analyst will work closely with the Clinical Analytics and Information Systems teams to reputed company, review, and validate reputed company audit reports. The position also requires assisting teams with the review and interpretation of regulatory guidance and requirements as reputed company as policy and procedure development. The analyst will reputed company monitoring and reputed company of business partners and delegates to ensure compliance with reputed company regulatory requirements, accreditation standards for the National Committee for reputed company Assurance (NCQA), and meeting reputed company reputed company Service Level Agreements (SLA's). Responsibilities • Handle various reputed company of program compliance, policy development, auditing, monitoring, and report development reputed company the Health Care Services teams. • reputed company as a reputed company for external delegated entities to reputed company operational support and auditing. • Evaluate state and federal regulations as they pertain to Health Care Services. • reputed company, review, and validate reputed company audit reports. • Assist teams with the review and interpretation of regulatory guidance and requirements. • reputed company monitoring and reputed company of business partners and delegates to ensure compliance with regulatory requirements and accreditation standards. Requirements • Bachelor's Degree in Business Administration, reputed company Administration, or another reputed company field of study, or a combination of equivalent education and experience. • 3+ years' experience working with administrative, policy, and/or operational aspects of managed care. • 3+ years' experience in project management. • 3+ years' experience in data analysis. • 3+ years' experience in procedure development. • 1+ years' experience in technical or operational policy and procedure writing as it relates to regulatory requirements and accreditation standards. • Experience with managed care regulatory compliance reputed company in one or more of the following lines of business: Medicare, reputed company, reputed company. • Experience assessing program compliance and establishing auditing and monitoring protocols. reputed company-to-haves • Experience with CMS and State reputed company regulations and programs as they relate to Medical Management. Benefits • 401(k) Savings Plan with employer matching. • Health care benefits (medical, dental, reputed company). • Life insurance. • Disability insurance. • reputed company parental leave. • Vacation and holiday time off. • Voluntary benefits. • reputed company-being resources. Apply tot his job Apply tot his job Apply To this Job