Operational Compliance Analyst

Job Summary

A company is looking for an Operational Compliance Analyst.

Key Responsibilities

• Respond to internal and external compliance-related requests and reporting
• Track and report compliance and contractual metrics to demonstrate performance
• Create and update Policies and Procedures (P&Ps) and Standard Operating Procedures (SOPs)

Required Qualifications

• Bachelor's degree or relevant experience equivalency
• At least 4 years of health plan experience, preferably in Compliance or Operations
• Working knowledge of CMS regulatory and sub-regulatory regulations
• Subject matter expertise in Claims, Risk Adjustment, Appeals and Grievances, and/or Billing is preferred
• Ability to manage multiple tasks and deliverables in a fast-paced environment