This position is responsible for the overall success of each audit or exam assigned. The Senior Audit Analyst, Provider Onboarding will analyze and review requested information, advise the business and/or form responses, and propose different options for resolving issues.
Requirements
- Analyzing and reviewing requested information
- Advising the business and/or forming responses
- Proposing different options for resolving issues
- Conducting meetings as needed (externally and internally)
- Collaborating with internal customers to ensure the audit/exam responses are accurate, timelines are met, and their internal activities are compliant
- Acting as a trainer and mentor to other team members
- Providing strong industry knowledge and understanding of the enterprise's structure
- Being a trusted SME for all audit/exam activities
- Managing all audits/exams as projects
- Establishing tasks, timelines, and deliverables to meet deadlines with dependencies on other departments
- Identifying, engaging, and collaborating with respective stakeholders throughout each project
- Creating and/or providing guidance in the drafting of audit/exam responses
- Analyzing unexpected findings or trends and sharing analysis, potential risks, and recommendations with stakeholders
- Completing Root Cause Analysis for each issue or Corrective Action Plan (CAP)
- Managing and tracking issue to completion to prevent repeat findings
- Providing monthly assessment on adherence to compliance standards, open corrective action plans, and/or performance guarantees
- Researching and resolving issues related to outdated information or unclear processes
- Creating and/or enhancing audit tools to mitigate potential future issues
- Leading cross-functional meetings to update stakeholders on pertinent issue resolutions, process changes and improvements, and/or system enhancements
- Acting as a subject matter expert to team members and consulting on complex or escalated issues
- Training and mentoring lower-level team members on department concepts, practices, procedures, policies, processes and/or issue resolution
- Creating and maintaining current desk level procedures (DLPs), reporting, training, and audit tools
- Providing guidance on monitoring audit/exam activities in order to meet compliance standards, contractual obligations, and/or performance guarantees with clients and legislative and regulatory bodies
- Analyzing policies, procedures, and business process modifications for compliance
- Serving as the primary point of contact for delegated credentialing entities, internal Regulatory, Ethics and Compliance partners, external auditors, regulators, examiners, and internal stakeholders
- Overseeing the review and assessment of the delegated credentialing agreement, credentialing files submitted by delegated entities to ensure compliance with contractual and regulatory requirements
- Issuing and tracking corrective actions related to credentialing audit findings
- Designing and enhancing audit tools, dashboards, and reporting mechanisms to proactively identify and mitigate risks associated with delegated credentialing
- Monitoring and interpreting legislative, regulatory, and accreditation changes related to credentialing delegation to assess potential impacts
Benefits
- Competitive base and incentive pay
- 401(k) with robust matching and non-matching contributions
- Rich medical & pharmacy benefits
- 100% employer-paid dental and vision benefits
- Holistic wellbeing program with deep financial incentives
- Generous paid time off plus 12 paid holidays and your birthday off
- Culture of growth and learning: career development; tuition reimbursement; recognition program
- Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
- Social responsibility and volunteer opportunities
- Employee discount program
- Fair Chance Ordinances and Criminal Background Considerations
