About this role
Role Overview
- Establish and maintain productive working relationships with internal departments and assigned external delegates to support ongoing compliance objectives.
- Track, analyze, report, and communicate audit activities and findings to delegates and relevant internal stakeholders in a timely and accurate manner.
- Review and evaluate delegates’ policies, procedures, and operational practices to ensure alignment with regulatory and contractual requirements.
- Identify compliance gaps and develop corrective action plans, partnering with delegates through resolution to ensure issues are addressed effectively and sustained.
- Serve as a compliance subject matter resource, providing consultation and guidance to support consistent and compliant business operations.
- Participate in special projects and process improvement initiatives designed to enhance departmental efficiency and effectiveness.
Requirements
- 5 or more years of demonstrated experience and understanding of regulations governed by the Department of Insurance and CMS
- 2-3 years of Audit or consulting experience
- Experience with metrics and reporting
- 2-3 years of Managed Care experience
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance