Act as a top-level specialist on project management and develop a comprehensive plan that encompasses objectives, deliverables, and timelines for CMS and/or State regulatory audits and readiness reviews
Ensure alignment on key deliverables and timelines and reinforce organizational standards
Apply highly developed knowledge of external audit standards and expectations to guide operational partners through all aspects of an audit, including data production, audit practice sessions, facilitation of audit sessions, delivery of post-audit deliverables, working with operations to mitigate audit risk, and oversight of root cause and corrective action planning
Analyze business documentation to ensure accurate and complete responses to auditor/regulator
Ensure operational processes are aligned with regulatory and organizational requirements
Oversee operational key performance indicators to measure progress and to analyze root cause and corrective action plans when goals are not achieved
Create a continuous improvement environment, looking for ways to enhance delivery processes and outcomes
Effectively manage multiple audits and projects and respond to change with adaptability
Use indirect management skills to ensure projects remain on track and escalate, as appropriate
Ensure implementation of new or revised regulatory requirements

7-10 years work experience in healthcare
Medicare and/or Medicare Integrated Duals/SNP Product Experience
In depth knowledge of CMS and/or State SMAC regulatory requirements, including experience supporting audits, validations, or regulatory reviews
Minimum of 3 years of experience leading projects or initiatives, including planning, execution, and delivery of results
Minimum of 3 years of experience in roles requiring high levels of accuracy and attention to detail
Strong problem solving and decision making skills, with the ability to analyze complex issues and recommend effective solutions
Experience dealing with state and/or federal regulators, including preparation of documentation, responses, and issue resolution
Demonstrated ability to manage multiple priorities and deadlines, while maintaining accuracy, completeness, and attention to detail
Excellent organizational and written communication skills, with a focus on clarity, precision, and professionalism
Demonstrated ability to work with all levels of the organization.

Senior Manager, Audit and Business Oversight

Key skills