Senior Compliance Analyst

Avesis

9d•$55,790 - $109,040•Remote

About The Position

Join us for an exciting career with the leading provider of supplemental benefits! Our Promise Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards. The Senior Compliance Analyst is part of the Audit and Corrections team will be responsible for facilitating health plan and regulatory audits, as well as related corrective action plan (“CAP”) activities and will report to the Compliance Director, Correction. This individual will be responsible for driving best practices across the company to promote compliance with audit and correction processes. This role is part of the Avesis Compliance Department. The Compliance Department plays a pivotal role in ensuring that Avēsis adheres to federal and state regulations, as well as internal policies. It is responsible for preventing, detecting, and correcting compliance risks that could impact the Avesis’ operational effectiveness as well as legal and reputational standing. The Compliance Department works to promote a culture of ethics, transparency, and accountability across the enterprise, making sure that all employees understand their responsibilities and the importance of adhering to legal, regulatory and compliance standards. Additionally, it provides ongoing training and resources to help staff stay informed about regulatory updates and best practices. The Senior Compliance Analyst will be primarily responsible for managing health plan and regulatory audit activity including, but not limited to, audit deliverable coordination, on-site audit coordination and management, and mock audit activities. The individual will also manage the corrective action process for health plan and regulatory CAPs. This role requires collaboration with stakeholders at all levels of the organization; therefore, candidates should demonstrate skillful communication, flexibility, and conflict resolution skills. It is a telecommuter role and an individual contributor with minimal travel.

Requirements

Ability to manage time effectively and efficiently
Ability to analyze data for accuracy
Ability to work independently and with minimal direction
Ability to demonstrate managing of projects
Proficient oral and verbal communication skills
Ability to demonstrate critical thinking skills
Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
Initiative: readiness to lead or take action to achieve goals.
Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
Member-focused: going above and beyond to make our members feel seen, valued, and appreciated.
Detail-oriented and thorough: managing and completing details of assignments without too much oversight.
Flexible and responsive: managing new demands, changes, and situations.
Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task.
Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and to keep information confidential when required.
Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.
Bachelor’s degree in business, healthcare, or related area of study, or equivalent education and work experience
3+ years of experience in compliance, privacy and/or regulatory affairs or with supporting audits in a highly regulated industry; preferably a government, health care or managed care environment
Intermediate level of proficiency with MS Word, Excel, and PowerPoint
Strong attention to detail
Able to work under pressure
Able to meet deadlines consistently
Able to work independently
As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 25 Mbps upload while hardwired and not on a VPN are sufficient.
Ability to travel as necessary (up to 25%)

Nice To Haves

Experience working with Medicare, Medicaid or Commercial benefits and regulations
Working knowledge of managed care and dental/vision benefit plans

Responsibilities

Coordinate all aspects of regulatory and client audits (i.e., pre-site deliverables, mock audits, on-site visits, logistics, and written responses to audit reports and corrective actions) and coordinate across times to document and track completion to ensure audit success.
Synthesize audit-related information (i.e., scope, findings, recommendations, corrective action plans, and status) and provide Compliance and business operations leadership written and oral reports of ongoing and completed audits
Simultaneously manage multiple audits and collaborate across multiple business areas to communicate gather necessary information within assigned due dates
Develop compliance communications
Problem solve and work closely with business partners on issue resolution
Research, understand, and articulate regulatory and contractual requirements
Educate business partners on regulatory audit processes as needed
Manage, track and report data related regulatory and client audits and CAPs
Coordinate with Legal Counsel as needed
Perform additional duties as requested or required by management

Benefits

Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
Competitive compensation package.
Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
Life and disability insurance.
A great 401(k) with company match.
Tuition assistance, paid parental leave and backup family care.
Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
Employee Resource Groups that advocate for inclusion and diversity in all that we do.
Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.