Quality and Reporting Analyst - Hybrid

$39,900 - $88,800/Yr

Health Care Service Corporation - Chicago, IL

Full-time - Entry Level

Hybrid - Chicago, IL

Insurance Carriers and Related Activities

About the position

This position is responsible for auditing operations compliance with accreditation and regulatory requirements in assigned areas, ensuring compliance with Plan, BCBSA, NCQA, and State and Federal requirements. The role involves researching and reporting on trends, recommending technical solutions, and preparing detailed reports to support projects and initiatives.

Responsibilities

• Audit operations compliance with accreditation and regulatory requirements.
• Research and report monthly on trends affecting accreditation requirements.
• Prepare monthly documented summaries and receipts related to compliance.
• Recommend and implement technical solutions to address compliance gaps.
• Gather, analyze, and prepare reports from various data sources.
• Support projects and initiatives by resolving issues across departments.

Requirements

• Bachelor's degree and 2 years of insurance experience OR 6 years of insurance experience.
• Knowledge of health care regulatory and legislative processes.
• Experience reading and interpreting legislation.
• Experience reviewing accreditation standards and evaluating compliance levels.
• Experience monitoring compliance and managing evidence documents.
• Experience preparing monthly reports and forecasting.
• Strong research and analytical skills.
• Detail-oriented with strong organizational skills.
• Ability to meet deadlines on time.
• Clear and concise verbal and written communication skills.
• PC proficiency in Word, Access, Excel, and Cognos.

Nice-to-haves

• Audit experience.
• Knowledge of Accreditation (i.e. NCQA, URAC, etc.).
• PC proficiency in Word, Excel, and PowerPoint.
• Knowledge of Premier Provider Web (PPW).
• Knowledge of quality review of Provider Data Entry Staff.
• Experience in provider networking, credentialing, and contracting.
• Knowledge of enterprise PDM business rules.
• Experience with NOSD internal systems (E-Status, PPW, CAQH, SF).
• Ability to handle multiple projects in a fast-paced environment.

Benefits

• Professional development opportunities.
• Flexible work schedule (hybrid role).
• Inclusive workplace culture.