Medical Management Compliance Analyst

Responsibilities

• Monitor and analyze regulatory/accreditation/business requirements to invoke recommendations for program and/or policy changes as appropriate for various lines of business.
• Lead/coordinate activities, which include internal audits, quality assurance control, quality improvement, provider satisfaction and department policies and procedures, to meet and/or maintain regulatory/accreditation/line of business requirements.
• Serve as a resource to internal and external staff regarding issues relating to administrative policies and procedures, medical policies, and researching and resolving problems.
• Edit all documentation generated by unit e.g., QIAs, reports, executive summaries, presentation materials, workplans, evaluations, annual plans, policies and procedures, minutes, agendas, provide feedback, and develop/generate monitoring reports/tools.
• Coordinate/schedule training opportunities and develop/present related reports and various documentation.
• Coordinate, support and document various department activities to ensure deliverables are completed by due date.
• Perform other duties (e.g., attend meetings) as assigned.

• Bachelor's Degree and two years of related work experience; or equivalent combination of education and related work experience.
• Strong oral and written communication skills;
• Excellent analytical, organizational and time-management skills.
• Recognized leadership abilities.
• Proficient in the use of all Microsoft Office applications and Internet searches.