Compliance Analyst III

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $83k - $132.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 1 day.
• Jobs at this company usually fill in 21 days.

Apply Now

Check your resume score

Customize resume + cover letter

Find Similar Remote Jobs

☆ Save☑️ Mark as applied❌ Hide

Report problem

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

• Provide Compliance Program support through audit and monitoring, corrective action management, data analytics, and other projects • Collaborate on and oversee high-risk areas to identify, prevent, detect, and correct non-compliance • Execute risk assessments, work plans, and other compliance activities • Support policy and procedure creation, training, education, implementation, and external reviews • Analyze and interpret regulatory requirements and provide compliance guidance • Support departments with implementation of health plan business and contractual requirements • Develop reports, policies and procedures, and readiness testing materials • Assist with annual compliance audit and monitoring workplans • Plan and execute audit and monitoring activities • Use analytics and research to identify risk, make recommendations, and escalate issues • Document corrective action plans, case summaries, and executive summaries • Develop and maintain corrective action plans through conclusion • Lead research, root-cause analysis, and gap analysis • Analyze deficiencies and develop appropriate corrective actions • Maintain compliance tool information • Develop strategic relationships with internal and external stakeholders • Mentor, shadow, and train new team members • Review and disseminate new and changing regulations and provide subject-matter expertise • Manage state and federal regulator inquiries • Perform other duties as requested

🎯 Requirements

• Bachelor’s degree in business or related field, or equivalent years of relevant work experience • Minimum of five (5) years of compliance and/or regulatory experience • Experience with Government Program products • Strong familiarity with Medicaid, Marketplace, and Medicare programs and compliance standards for First Tier, Downstream and Related entities • Advanced data analysis ability • Familiarity with healthcare operations and/or clinical concepts, practices and procedures • Understanding of compliance and regulatory fundamentals related to managed care and government programs, including CMS/HHS/DOI/Medicaid • Knowledge of internal and external audit functions and procedures • Ability to conduct Federal, State, and industry regulatory and enforcement research and analysis • Advanced ability to interact directly with regulators • Expert written and verbal communication, grammar, document structure, and business writing skills • Ability to organize schedules for compliance meetings, audit conferences, audit sessions, and vendor reviews • Expert work management, prioritization, preparation, scheduling, and resource-leveraging skills • Expert change-management ability • Ability to work independently and collaboratively in a cross-functional environment • Success working in a matrixed environment • Strategic relationship-management skills • Expert attention to detail and critical thinking skills • Expert organizational, project management, and scheduling skills • Proven negotiation skills and experience • Time management skills, including creating and maintaining project timelines • Advanced Microsoft Word, Excel, and PowerPoint experience • Expert reading and comprehension skills • Expert decision-making and problem-solving skills • Expert administrative experience • Certified in Healthcare Compliance (CHC) or Certified Compliance and Ethics Professional (CCEP) preferred • Current, unrestricted clinical licensure may be desired for clinical-focus positions • Functional business licensure/certification may be desired

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Employee total well-being support

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume