Regulatory Audits Monitoring Specialist

Job Summary

A company is looking for a Regulatory Audits & Monitoring Specialist.

Key Responsibilities:

• Assist with all regulatory audits (state & federal)
• Coordinate year-round audit readiness activities, pre-audit deliverables, onsite scheduling and auditor requests, post-audit reviews and deliverables, post validation reviews, and audit project plans and calendars
• Contribute to the development of policies and procedures for the plan's audit process, repository, and readiness activities

Required Qualifications:

• Bachelor's Degree or equivalent work experience
• At least five (5) years' experience in managed health care
• 3+ years compliance experience
• Demonstrated knowledge of the Medicare Advantage Program and its governing regulations
• Proven ability to interact effectively with staff from all levels of the plan