Compliance Analyst II External Audit

@ CareSource

Job Summary

The Compliance Analyst II External Audit role supports the Compliance Program by collaborating across high risk areas to ensure effective identification, prevention, detection, and correction of noncompliance.

Essential Functions

Compliance Prevention: Provide analysis, interpretation, training, and education on compliance requirements. Support departments with requirement implementation, reporting development, policy and procedure review, and readiness testing. Collaborate with internal business owners to implement business and contractual requirements and work with Compliance leadership to interpret regulations. Assist in reviewing and disseminating Regulatory Distribution Management updates and guide teams on the impact for high-risk areas.

Compliance Detection: Support audit and monitoring, corrective action plan management, data analytics, and other projects. Analyze performance data to ensure compliance, prepare leadership reports, and proactively identify risk areas through research and analytics. Coordinate audit activities with subject matter experts and maintain proper documentation per Corporate Compliance protocols.

Compliance Correction: Investigate risks using root cause and gap analysis. Document corrective actions, case summaries, and executive summaries with recommended process improvements.

Account Relationship: Build and maintain strategic relationships with internal and external stakeholders, attend required state regulator meetings, manage deliverables, and provide guidance to business areas. Perform additional duties as needed.

Education And Experience

Bachelor’s degree in business or related field (or relevant experience) and minimum three years of compliance/regulatory experience including one year in Government Program products.

Competencies, Knowledge And Skills

• Familiarity with government-funded healthcare programs and compliance standards.
• Understanding healthcare operations, clinical concepts and processes (preferred).
• Strong data analysis, research, and report preparation skills.
• Expertise in internal and external audit functions.
• Excellent written and verbal communication skills.
• Advanced organizational, project management and decision making abilities.
• Proficiency in Microsoft Word, Excel, and PowerPoint.

Licensure And Certification

Certification in Healthcare Compliance (CHC) or Compliance and Ethics Professional (CCEP) is preferred. Clinical licensure (LPN, RN, etc.) may be beneficial for positions with a clinical focus.

Working Conditions & Compensation

General office environment; may require extended periods of sitting or standing. Salary ranges from $70,800 to $113,200 plus potential bonus tied to performance. Comprehensive total rewards package offered.

Competencies

Create an Inclusive Environment, Cultivate Partnerships, Develop Self and Others, Drive Execution, Influence Others, Pursue Personal Excellence, Understand the Business.

Key skills/competency

• Compliance
• Audit
• Regulation
• Healthcare
• Risk
• Analytics
• Documentation
• Investigation
• Communication
• Project Management