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Integrity Analyst - Health First Health Plans Corporate Integrity Full Time

Location
Rockledge, FL, United States

Posted on
May 25, 2021

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Integrity Analyst - Health First Health Plans Corporate Integrity, Full Time','053563','!*!POSITION SUMMARY

This role is responsible for maintaining knowledge of corporate integrity issues and staying current on trends and developments in the field; conducting monitoring and audit initiatives while providing recommendations and guidance to enhance organizational corporate integrity and minimize risk. The individual must take ownership of routine duties and assigned projects, discussing and seeking approval of complex matters on a limited basis.

 

PRIMARY ACCOUNTABILITIES

1. Collaborates to investigate, direct and resolve compliance issues through appropriate existing channels

2. Organize, implement, and effectively meet the 7 Elements of the Compliance Program specific to guidelines adopted by both the Centers for Medicare & Medicaid Services and the Office of Inspector General.

3. Implements effective monitoring of appropriate compliance indicators to oversee high-risk areas, routinely reports areas of interest or concern to leadership.

4. Identify the types and quantity of information/evidence needed to complete assigned audit tasks, how to efficiently obtain such information, analyze it within the context of the audit objectives, and to formulate appropriate subsequent actions and recommendations. Consistently document relevant facts and information to support the audit and conclusions so others can follow the logic and methodology.

5. Calculates and reports findings and observations in a clear manner, identifying high risk areas for further auditing.

6. Documents and tracks incidents appropriately providing updates and summarizing compliance activities and events monthly in clear and concise written reports.

7. Identifies process improvements and areas of interest or potential risk effectively communicating points through clearly written correspondence or Compliance Memorandums.

8. Designs, develops, and supports compliance-based training and education curriculum to promote the integrity program and enhance organizational compliance.

9. Analyze and interpret government regulations to acquire and maintain knowledge.

10.Assist in assessing impact on current processes, review, create and/or revise policies and procedures and assist with education accordingly.
','!*!QUALIFICATIONS

 Education: Associate’s Degree

 Licensure: None Required

 Certification: None Required

 Work Experience: Three years of compliance experience

 Knowledge/Skills/Abilities:

    o Proficient in Microsoft Office – Outlook, Word, Excel, PowerPoint

    o Demonstrated proficiency in understanding and analyzing federal and state health care rules and regulations, including HIPAA

    o Demonstrated ability to educate associates on compliance related matters.

    o Effective interpersonal, written, and verbal communication skills and ability to work with all levels of health care personnel, including Executive   management

    o Excellent time management, planning and organization skills, detail-oriented

    o Strong critical thinking skills

    o Ability to work independently with minimal supervision and exercise professional judgment regularly.

    o Self-confidence and composure to handle stressful, emergent, and dynamic work situations in a team environment often while managing              multiple, concurrent, highpriority tasks

    o Persistence and attention to detail to produce high-quality, professional-looking work products and to continuously improve personal performance

    o Demonstrates strong customer service skills

 

PREFERRED QUALIFICATIONS

 Education: Bachelor’s Degree in Healthcare Administration

 Licensure: None Required

 Certification: Certification in Compliance by recognized accrediting organization.

 Work Experience: Three or more years supporting Vice President or above in healthcare

 Knowledge/Skills/Abilities: Decision-making, Financial acumen
','Corporate Services','Health First, Incorporated','United States-Florida - Brevard County-Rockledge','','Full-time','8:00 am - 4:30 pm','8:00 am - 4:30 pm','Associate','Integrity Analyst - Health First Health Plans Corporate Integrity, Full Time

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