What are the responsibilities and job description for the Compliance Audit Analyst position at McLaren Health Care?
McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Compliance Audit Analyst, to join in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary:
Responsible for identification, analysis, and performance of compliance audits in all lines of business, consistent with State, Federal, and Health Plan policies, regulations, and contractual requirements, not limited to, detect, prevent, and respond to potential instances of non-compliance.Responsible for supporting all aspects of the Compliance Program. Performs quality assurance activities on analytics for all product lines to identify non-compliance with regulations and procedures.Analyzes, reviews, and presents information on audit outcomes to support business decisions.
This position is fully remote.
Qualifications:
Required:
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary:
Responsible for identification, analysis, and performance of compliance audits in all lines of business, consistent with State, Federal, and Health Plan policies, regulations, and contractual requirements, not limited to, detect, prevent, and respond to potential instances of non-compliance.Responsible for supporting all aspects of the Compliance Program. Performs quality assurance activities on analytics for all product lines to identify non-compliance with regulations and procedures.Analyzes, reviews, and presents information on audit outcomes to support business decisions.
This position is fully remote.
Qualifications:
Required:
- Associate Degree in business, health care or related field.
- Two (2) years of progressively more responsible position using auditing and/or analytical skills.
- Bachelor’s Degree in business, health care or related field.
- Two (2) years of compliance or related experience in health care or related field.
- Two (2) years’ experience and knowledge of HMO, or PPO Course work or work experience in statistics.
- Schedule: Full-time
- Requisition ID: 26000579
- Daily Work Times: 8:30 am - 5:00 pm
- Hours Per Pay Period: 80
- On Call: No
- Weekends: No