Compliance Analyst I

CareSource•Dayton, OH

3d•$62,700 - $100,400

About The Position

The Compliance Analyst I supports the Compliance organization by helping execute its work plan and priorities through audits and monitoring, departmental projects, and data analytics. The role manages compliance requests in designated tools; coordinates audit activities with business owners and subject matter experts; and works with internal partners to prepare accurate documents, reports, and data for regulatory agencies. It identifies irregular trends and potential compliance risks, tracks adherence statistics, researches root causes and gaps, and supports corrective action plans through resolution. The position also supports cross-functional projects, compliance training, internal quality reviews, and recurring business continuity and audit processes involving physical content. It works with Compliance leadership to interpret regulations and provide guidance, builds relationships across business departments, and may manage regulator complaints or help maintain records and information management and corporate policy and procedure governance programs. The role performs other job-related duties as requested. The job is based in a general office environment. It may require extended periods of sitting or standing and lifting or moving objects such as boxes weighing up to 50 pounds. The listed compensation range is $62,700 to $100,400, with potential eligibility for a bonus tied to company and individual performance. CareSource also describes a substantial and comprehensive total rewards package.

Requirements

Bachelor’s degree or equivalent years of relevant work experience.
One to two years of experience in a health care-related field, or equivalent experience in managed care, compliance, a regulatory environment, policy and procedure development and oversight, or records and information management.
Ability to work independently in a fast-paced, cross-functional environment with changing priorities.
Strong interpersonal and verbal and written communication skills.
Professional communication skills, including proper grammar, document structure, and business writing for audiences such as internal leadership, Legal Counsel, Corporate Compliance, and state and federal regulators.
Ability to work independently and as part of a team.
Demonstrated success working in a matrixed environment and maintaining positive, strategic relationships with internal stakeholders.
Strong analytical, problem-solving, and critical-thinking skills, with attention to detail.
Knowledge of the regulatory environment and a general understanding of audit protocols.
Ability to read, comprehend, and adhere to process documents, contractual requirements, and technical specifications required by auditors and regulators.
Ability to evaluate internal business partners’ adherence to procedures, contractual requirements, and technical specifications required by auditors and regulators.
Familiarity with healthcare operations and/or clinical concepts, practices, and procedures.
Ability to manage multiple responsibilities and projects with competing priorities and deadlines.
Understanding of data analysis and trending techniques for meaningful reporting.
Customer service and member-focused orientation.
Ability to develop and prioritize goals, leverage resources, and accomplish objectives.
Strong project scheduling and time management skills, including creating and maintaining project timelines.
Ability to follow procedures, ensure high-quality output, and take action to correct problems.
Knowledge of IT and enterprise software applications and platforms such as SharePoint, OnBase, and Adobe.
Proficiency in Microsoft Word, Excel, and PowerPoint.

Nice To Haves

Certified Records Analyst (CRA) certification.
Certified Healthcare Compliance (CHC) certification.
Certified Compliance Ethics Professional (CCEP) certification.

Responsibilities

Support the Compliance Program through internal or external audits and monitoring, departmental projects, and data analytics.
Enter and manage compliance requests in designated compliance tools.
Support or coordinate audit activities with impacted business owners to ensure appropriate subject matter expert representation.
Collaborate with internal business owners to determine appropriate actions and deliver accurate documents, reports, and data universes to regulatory agencies on time.
Identify and communicate irregular trends, recommend potential improvements, and relay information to management for research when necessary.
Track and report key statistics related to adherence to internal and external requirements.
Collaborate with internal business partners to identify workflow efficiencies and maximize productivity.
Perform recurring business continuity and audit processes related to physical content, as needed.
Support internal projects and work with cross-functional teams to complete deliverables.
Assist with developing, reviewing, and delivering compliance support training within Compliance and other business areas.
Assist with developing and maintaining corrective action plan information through issue resolution.
Conduct research, root cause analysis, and gap analysis.
Work with Compliance leadership to interpret regulations and provide related guidance.
Coordinate the internal quality review process to ensure consistency in submissions and communications to regulatory agencies.
Identify potential compliance vulnerabilities and risks, and report potential risks, non-compliance, or alleged violations to appropriate Compliance leadership.
Build working relationships and credibility with business departments to support a culture of compliance.
Collaborate across corporate, markets, plans, other assurance functions, and business partner areas to foster a culture of compliance.
Analyze relevant business and/or delegate/FDR performance data and prepare reports for leadership and business owners.
May manage complaints received through regulators or other governing bodies and maintain the Records & Information Management Program and Corporate Policy & Procedure Governance.
Perform other job-related instructions as requested.