Davis Vision Inc.
Davis Vision | Superior Vision is a leading provider of vision and eye health solutions offering services to the full spectrum of the vision care marketplace, including employer groups, health plans, and government-sponsored programs. We deliver value to our members through our extensive access to providers and having the industry's broadest, most diverse networks. No other vision carrier comes close to the size, accessibility, and diversity we offer. We have built lasting relationships based on one foundational principle: our members are our highest priority. Every department embodies a member-centric approach to service.
We are an innovative company that is always looking forward and adapting our comprehensive portfolio of products to match -- and anticipate -- what our customers need. We are a true partner with our customers by leading and guiding them to make the best choice.
We are committed to a culture of delivering outstanding service, provider access, and member and customer value. You'll find a strong commitment to ensuring our culture also embraces quality and continuous improvement. We seek associates who are creative thinkers with fresh insights, who thrive in a dynamic, customer-centric environment.
Scope and Purpose of Position:
The Senior Analyst works independently in leading the planning and execution of regulatory-based operational audits performed by clients and regulatory / government agencies. The Senior Analyst will partner with the business to optimize audit performance and outcomes. The Senior Analyst will work with management to develop corrective action plans to address audit issues identified by clients / regulators and monitor progress of remediation through to closure. The Senior Analyst serves as the organization subject-matter expert in preparing for and facilitating CMS audit activities (ODAG / SARAG).
Facilitate regulatory-based client and third party audits and assessments to include scheduling, coordination, internal notification, scope determination and oversight
Facilitate internal notification, training, scope confirmation and continued oversight through to closure
Subject-matter expert to the organization for ODAG / SARAG CMS audit activities including mock audit activities
Assists in delivering training and feedback to staff and business process owners on audit facilitation and related processes
Provides communication of audit results, and supports the development of Company response to report issuance
Assists in development, monitoring, validation and reporting of all Corrective Action Plans (CAPs)
Assists in the development of departmental policies and procedures that support compliant departmental operations
Support the completion of departmental reporting to both internal and external customers
Support the completion of other audits as needed to meet departmental needs
Provide project management skills, develop work plans and act as Project Lead for all assigned projects
Completion of special projects, programs, requests and all required documentation to meet department standards, as needed
Interface with external customers whenever needed
Respond to and follow up on Audit Management inquiries received from internal and external customers within established timeframes
Prioritize essential responsibilities to ensure that business needs are met
All other duties as assigned
Bachelor's degree in related field, preferred.
Or equivalent combination of experience and education.
Three (3) years' progressive business operations experience, preferably in managed care or retail optical.
Three (3) years' progressive compliance / regulatory auditing experience, preferably in managed care environment.
Three (3) years' progressive delegation oversight experience, preferably with URAC and NCQA requirements.
Excellent PC skills; proficiency with MS Office applications including Excel and Access highly desirable.
Ability to access, compile and analyze large volume data sets into concise and precise information
Ability to understand and analyze metrics
Ability to define business processes into manageable components
Excellent analytical skills
Excellent presentation skills
Strong skills in negotiating, relationship building, problem solving, and timely problem escalation
Ability to work independently as well as part of a team
Ability to multi-task
Excellent organizational skills
Ability to work onsite and participate in interactive onsite meetings on a regular and predictable basis
Ability to initiate immediate interaction, coordination and collaboration with team members, clients, customers etc.
If you are prohibited from working on a government contract, this may disqualify you from consideration for this position.
We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, sex, gender identity, sexual orientation, age, marital status, national origin, ancestry, physical or mental disability or history of disability, genetic information, status as a protected veteran or disabled veteran, or any other status protected by Federal, state or local law.
Davis Vision Inc.
Website : http://www.davisvision.com