Business Analyst – Program Integrity Vendor Audits (Remote)

Sentara Health is looking for a meticulous and analytical Business Analyst to oversee the management of third-party vendors. This role will be responsible for analyzing vendor performance, identifying cost-saving opportunities, and ensuring vendor compliance with various standards.

Responsibilities:

• Analyze audit findings and vendor performance data to identify trends, risks, and improvement opportunities
• Data extraction & Analysis
• Regulatory Reporting & KPI Development
• Serve as a liaison between vendors and providers to resolve issues and improve service delivery
• Track and evaluate vendor performance using KPIs and SLAs
• Conduct regular vendor reviews and audits to ensure compliance and quality standards
• Evaluate vendor adherence to Business Associate Agreements (BAAs), SLAs, and quality standards
• Recommend enhancements to vendor audit frameworks, tools, and documentation practices
• Contribute to the development of policies and procedures for vendor oversight and governance
• Support continuous improvement initiatives in vendor lifecycle management
• Maintain documentation of audit procedures, findings, and follow-up actions
• Contribute to the development of vendor audit policies and workflows

Requirements:

• Bachelor's Degree (Required)
• 3+ years of relevant experience in business analysis, data reporting, or analytics (Required)
• Must have 3+ years of experience in business analysis, auditing, claims, vendor management, or compliance
• Required to have experience working with health insurance, claims data, and auditing claims data
• Excellent written and verbal communication skills
• Knowledge of Databricks
• Knowledge of SQL
• Experience in regulated industries (e.g., healthcare, finance, insurance)
• Experience and/or knowledge of medical coding and inpatient auditing