Compliance Analyst I

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $62.7k - $100.4k / year

⏰ Full Time

🟢 Junior

🚔 Compliance

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Support the Compliance Program through internal or external audits, monitoring, departmental projects, and data analytics • Perform data entry and manage compliance requests in designated compliance tools • Support and coordinate audit activities with business owners and subject matter experts • Coordinate delivery of accurate documents, reports, and data universes to regulatory agencies • Identify irregular trends and communicate improvement opportunities to management • Track and report key statistics for internal and external requirements • Identify workflow efficiencies with Internal Business Partners • Perform recurring business continuity and audit processes related to physical content • Support internal projects and collaborate with cross-functional teams on deliverables • Assist with developing, reviewing, and delivering compliance support training • Maintain corrective action plan information through issue resolution • Conduct research, root cause analysis, and gap analysis • Interpret regulations and provide guidance with Compliance leadership • Coordinate internal quality review processes for regulatory submissions and communications • Identify and report compliance vulnerabilities, risks, non-compliance, and alleged violations • Build relationships with Business Departments to support a culture of compliance • Collaborate across Compliance functions, corporate teams, markets, plans, assurance functions, and business partners • Analyze business and delegate/FDR performance data and prepare reports • Manage complaints received through regulators or governing bodies as needed • Maintain the Records & Information Management Program and Corporate Policy & Procedure Governance as needed • Perform other job-related instructions as requested

🎯 Requirements

• Bachelor’s degree or equivalent years of relevant work experience is required • One (1) to two (2) years in a health care related field is required, or equivalent experience in managed care, compliance, regulatory environment, policy and procedure development and oversight, and/or records and information management • Ability to work independently in a fast-paced cross-functional environment with changing priorities • Strong interpersonal and verbal/written communication skills • Professional communication skills, including proper grammar usage, document structure, and business writing • Ability to work independently and within a team environment • Success working in a matrixed environment • Strong analytical, problem solving, and critical thinking skills, with attention to detail • Knowledge of regulatory environment and general understanding of audit protocols • Ability to read, comprehend, and adhere to process documents, contractual requirements, and technical specifications required by auditors and regulators • Ability to evaluate business partners’ adherence to procedures, contractual requirements, and technical specifications • Familiarity with healthcare operations and/or clinical concepts, practices, and procedures • Ability to manage multiple responsibilities and projects with competing priorities and deadlines • Understanding of data analysis and trending techniques • Ability to develop, prioritize, leverage resources, and accomplish goals • Strong time management and project scheduling skills, including creation and maintenance of project timelines • Knowledge of IT and enterprise software applications and platforms such as SharePoint, OnBase, and Adobe • Proficient in Microsoft Word, Excel, and PowerPoint • Certified Records Analyst (CRA), Certified Healthcare Compliance (CHC), or Certified Compliance Ethics Professional (CCEP) certification preferred

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Remote work arrangement

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