Analyst, Compliance Auditing, Monitoring and Analytics

Job Description Summary

The Analyst, Compliance Auditing, Monitoring and Analytics is responsible for supporting the Compliance program’s risk-based auditing, monitoring and analytics activities to monitor, assess, and optimize compliance with all laws, regulations and guidelines with Federal and State programs. This role requires a strong level of auditing and analytical skills, and the ability to summarize and communicate complex findings effectively. Reporting to the Senior Manager, Compliance Auditing, Monitoring and Analytics, this individual assists in executing monitoring and auditing projects, to include standard, repeatable processes identifying, documenting and presenting any errors, irregularities or findings, and completion of necessary corrective actions.

Partners with other functional areas and field teams to coordinate audit and monitoring activities from initiation through completion of corrective action. Designs and implements robust analytics and continuous monitoring strategies to prevent, detect and mitigate compliance risks.

Job Responsibilities (listed in order of importance and/or time spent)

• Executes the risk-based compliance auditing, monitoring and analytics program to assess the effectiveness of compliance controls and processes across the organization in alignment with the Compliance organizations risk assessments and workplans.

• Coordinates with internal stakeholders to identify audit objectives, scope, and methodologies, and ensure alignment with organizational priorities.

• Conduct periodic compliance audits and reviews in accordance with established Compliance workplans, focusing on key risk areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse.

• Perform data analysis and review of documentation to identify potential compliance issues, irregularities, or trends, and develop recommendations for corrective actions or process improvements.

• Monitor compliance with policies, procedures, and regulations through ongoing monitoring activities, including data analysis, trend analysis, and review of key performance indicators.

• Collaborate with cross-functional teams to implement corrective actions and remediation plans in response to audit findings, and track progress to ensure timely resolution.

• Identifies policy, procedure, and process gaps and partners with functional leaders to develop responsive corrective measures to prevent reoccurrences.

• Prepare and present regular reports on audit and monitoring activities, findings, and outcomes to be shared with leadership and regulatory authorities as required.

• Maintain documentation of audit and monitoring activities, including work papers, findings, recommendations, and corrective actions, in accordance with established recordkeeping requirements.

• Utilize advanced analytics techniques to analyze large datasets, such as related to healthcare operations, billing, claims, and patient information to support Compliance activities and to identify trends, anomalies, and potential compliance risks.

• Design and build monitoring dashboards and other data visualizations using common tools such as Power
  
  BI; leverage other Microsoft suite tools as well to collect, organize and analyze data.

• Collaborate with cross-functional teams to develop and implement analytics-driven, risk-based capabilities to continuously monitor compliance with internal policies and federal, state, and local regulations.

• Always respect and maintain the confidentiality of sensitive business and patient information.

• Always maintain files and work papers consistent with Option Care Health policy and compliance processes.

• Stay abreast of changes in healthcare regulations, industry trends, and best practices in compliance auditing and monitoring and analytics, and proactively identify opportunities to enhance compliance processes and systems.

Does this position have supervisory responsibilities?

(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

No X

Yes

• Bachelor;s degree in business, auditing, accounting, data science, finance, statistics, healthcare administration, or related field. Comparable professional experience will be considered.

• Minimum of 2-3 years of experience in compliance, audit, analytics or related field involving conducting data analysis and building digital tools such as dashboards and other types of reporting.

• Demonstrated experience in supporting risk management of an organization, including but not limited to, Compliance, Internal Audit, Finance/Accounting, Enterprise Risk Management, IT Governance & Controls.

• Demonstrated experience designing and implementing auditing and/or monitoring programs. Intermediate proficiency in analysis and audit techniques and documentation review, with the ability to be thorough and objective.

• Strong analytical, problem-solving, and…