Medicare Advantage External Audit Specialist

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🕒 Junho 25

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RAM Technologies

SiteLinkedInTodas as Vagas

1 - 10 funcionários

Fundada em 1996

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

A RAM Technologies é uma fabricante norte-americana de fontes de alimentação de alta confiabilidade para os setores médico e industrial, além de acessórios relacionados. Desde 1996, a empresa projeta e produz fontes de alimentação para PC certificadas para dispositivos médicos e outras aplicações industriais, enfatizando rápida entrega para protótipos, cabos de saída personalizáveis e conformidade com normas como a EN 60601-1. A RAM Technologies oferece produtos duráveis, com garantia e fabricados nos EUA, direcionados para OEMs e designers de eletrônicos médicos e industriais.

Descrição

• Coordinate all aspects of external client, regulatory, and compliance audits involving Medicare Advantage, SNP, Part D, and Managed Medicaid plans and related healthcare operations. • Serve as the primary liaison between auditors, regulators, health plan clients, and internal operational departments. • Manage audit timelines, deliverables, evidence requests, and response tracking. • Coordinate collection, validation, organization, and submission of audit documentation and supporting evidence. • Schedule audit meetings, interviews, walkthroughs, and status updates with internal and external stakeholders. • Monitor audit progress and communicate status updates, risks, and deadlines to Chief Compliance Officer and Compliance Committee. • Track audit findings, corrective actions, remediation plans, and response due dates. • Assist with preparation for recurring CMS, client, and regulatory oversight activities • Support internal compliance and vendor oversight audit activities. • Assist with compliance monitoring and oversight activities across operational areas. • Support policy and procedure review and maintenance activities. • Assist with issue tracking, investigations, and documentation management. • Participate in internal risk assessments and compliance reviews. • Support preparation of compliance reports, dashboards, presentations, and committee materials. • Maintain strict confidentiality of Protected Health Information (PHI), proprietary information, and sensitive client data. • Maintain awareness of applicable CMS Medicare Advantage regulations, guidance, and audit expectations.

🎯 Requisitos

• Bachelor’s degree or equivalent experience in healthcare administration, business administration, compliance, legal studies, public health, finance, or related field preferred. • Minimum of 2–5 years of experience in Medicare Advantage audit coordination or project management of CMS audits, delegation oversights, data validation audits, financial audits, and/or HIPAA audits. • Experience coordinating external audits, regulatory requests, or client oversight activities preferred. • Strong project coordination and organizational skills. • Excellent written and verbal communication abilities. • Ability to manage multiple priorities and deadlines simultaneously. • Strong follow-through, accountability, and time management skills. • Attention to detail and documentation accuracy. • Ability to interact professionally with regulators, auditors, clients, executives, and operational teams. • Proficiency with Microsoft Office Suite, including Excel, Word, PowerPoint, and Teams. • Compliance certification preferred, such as Health Care Compliance Association CHC, CHPC, CCEP, or similar.

🏖️ Benefícios

• 100% remote work culture • 5 weeks of vacation • Health, dental & vision insurance • Traditional and ROTH 401k with company match • Company paid life insurance, AD&D, and long-term disability coverage • HSA and FSA accounts • Tuition Reimbursement • Parental Leave