About the role

  • Responsible for auditing operations compliance with accreditation and regulatory requirements in assigned areas.
  • Ensuring compliance with Plan, BCBSA, NCQA and State and Federal requirements.
  • Researching and reporting monthly on trends.
  • This will include monthly documented summaries, receipts, and how these impact accreditation requirements.
  • Recommending and implementing technical solutions and communicating to the management team of the need/gap.
  • Gathering data, analyzing data, and preparing reports including disseminating information from various sources and systems.
  • Supporting projects and initiatives and resolving issues by working with staff within the department or across departments.

Requirements

  • Bachelor’s degree and 2 years of insurance experience OR 6 years’ insurance experience.
  • Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation.
  • Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges and proposing solutions.
  • Knowledge or experience monitoring compliance and managing evidence documents.
  • Experience preparing monthly reports and forecasting.
  • Research and analytical skills.
  • Detail orientation and organizational skills; experience meeting deadlines on time.
  • Clear and concise verbal and written communication skills.
  • PC proficiency to include Word, Access, Excel and Cognos.

Benefits

  • Health and wellness benefits
  • 401(k) savings plan
  • Pension plan
  • Paid time off
  • Paid parental leave
  • Disability insurance
  • Supplemental life insurance
  • Employee assistance program
  • Paid holidays
  • Tuition reimbursement

Job title

Quality and Reporting Analyst – Audit

Job type

Experience level

JuniorMid level

Salary

$40,900 - $91,000 per year

Degree requirement

Bachelor's Degree

Tech skills

Location requirements

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