Position Purpose: Under the direction of the Director of Compliance and Regulatory Affairs (Compliance Officer), the Compliance Analyst helps to implement the compliance program for Steward Health Choice’s health plan and accountable care organization. The Compliance Analyst will focus on compliance and operational auditing and monitoring of activities while providing support to the Compliance Officer in all other aspects of the compliance program.
- Collaborate with the Director of Compliance in designing and executing internal and external audits.
- Conduct compliance and privacy investigations.
- Assist Compliance Officer in conducting risk assessments of business practices to determine areas of exposure.
- Develop and track compliance corrective action plans that result from audits.
- Conduct research analysis on regulatory requirements.
- Provide education to staff on compliance related laws, regulations and standards.
- Track and submit regulatory deliverables.
- Make recommended changes to procedures and practices that are not in compliance with laws and regulations.
- Monitor changes to laws and regulations to ensure compliance with state and federal laws, regulations and mandates.
Education / Experience / Other Requirements
- Must possess a Bachelor's degree in law, health administration, business administration, finance/accounting or related field.
Years of Experience:
- Three years of Medicaid and ERISA compliance experience.
- Three years of compliance audit or internal audit experience.
- Strong knowledge of federal and state health care compliance related regulations, including ERISA.
- Certified Internal Auditor (CIA) or similar designation given preference.
- Managed care auditing experience highly preferred.
- Strong report writing and presentation skills.