<p>Job Requirements</p> <p>POSITION SUMMARY</p> <p>The Audit Integrity Analyst ensures organizational integrity and compliance by monitoring and auditing</p> <p>internal operations and vendor activities, providing recommendations to align with laws, regulations,</p> <p>and policies. The Audit Integrity Analyst plans and executes audits, prepare detailed reports, and</p> <p>present findings to management. The Audit Integrity Analyst stays informed on industry trends and</p> <p>manages routine duties and projects with minimal supervision, seeking guidance only for complex</p> <p>matters.</p> <p>PRIMARY ACCOUNTABILITES</p> <ol> <li>Collaborates to investigate, direct and resolve compliance issues through appropriate existing </li></ol> <p>channels.</p> <ol start="2"> <li>Implements effective monitoring and auditing of appropriate compliance indicators to oversee </li></ol> <p>high-risk areas and assist in managing external audits from government entities.</p> <ol start="3"> <li>Assists with conducting the annual risk assessment and workplan build process to identify key </li></ol> <p>areas of concern within the Health Plan Operational Teams, and applicable vendors.</p> <ol start="4"> <li>Plans, develops, and recommends objectives, audit steps, and tools to be used in auditing and </li></ol> <p>monitoring of operational departments and vendors.</p> <ol start="5"> <li>Identifies the types and quantity of information and evidence needed to complete assigned audit </li></ol> <p>tasks, how to efficiently obtain such information, analyze it within the context of the audit</p> <p>objectives, and to formulate appropriate subsequent actions and recommendations.</p> <ol start="6"> <li>Examines business and vendor procedures, analyzes data, verifies accounts, and inspects </li></ol> <p>operations to ensure compliance and maintain adequate controls.</p> <ol start="7"> <li>Consistently and accurately document relevant facts and information to support the audit, </li></ol> <p>monitoring and conclusions so others can follow the logic and methodology.</p> <ol start="8"> <li>Presents the results of audits and monitoring to appropriate management, which may include </li></ol> <p>executive leadership, by calculating outcomes, documenting findings and observations,</p> <p>identifying high risk areas for further auditing, in a clear and consider manner through an</p> <p>audit/monitoring report.</p> <ol start="9"> <li>Assesses and recommends action to be taken when control, operational weaknesses, and </li></ol> <p>compliance issues are found.</p> <ol start="10"> <li>Works with business areas to implement corrective actions and follows department processes to </li></ol> <p>ensure they are effectively executed in a timely manner.</p> <ol start="11"> <li>Analyzes and interprets government regulations to acquire and maintain knowledge. </li></ol> <p>Work Experience</p> <p>MINIMUM QUALIFICATIONS</p> <ul> <li>Education: Bachelor's degree in Healthcare, Business Administration, or relevant field. </li><li>Work Experience: Four (4) years' experience in compliance. </li><li>Licensure: None </li><li>Certification: None </li><li>Work Experience in Lieu of Education: Two (2) years' experience in compliance. </li><li>Skills/Knowledge/Abilities: </li></ul> <p>o Proficient in Microsoft Office - Outlook, Word, Excel, PowerPoint.</p> <p>o Demonstrated proficiency in understanding and analyzing federal and state health care rules and regulations, including HIPAA.</p> <p>o Excellent interpersonal, written, and verbal communication skills and ability to work with all levels of health care personnel, including Executive management.</p> <p>o Excellent time management, planning and organization skills, detail oriented.</p> <p>o Strong critical thinking and analytical skills needed to identify key controls, business process improvements, evaluate alternatives and develop effective audit/monitoring recommendations.</p> <p>o Ability to work independently with minimal supervision and exercise professional judgment regularly.</p> <p>o Self-confidence and composure to handle stressful, emergent, and dynamic work situations in a team environment often while managing multiple, concurrent, high- priority tasks.</p> <p>o Persistence and attention to detail to produce high-quality, professional-looking work products and to continuously improve personal performance.</p> <p>o Demonstrates strong customer service skills.</p> <p>PREFFERED QUALIFICATIONS</p> <ul> <li>Education: Master's degree in Healthcare Administration, Business, or related field. </li><li>Work Experience: Prior Experience specifically related to auditing and monitoring, as well as in-depth knowledge of health plan operations. </li><li>Certification: </li></ul> <p>o Certified Professional Coder for Payers (CPC-P).</p> <p>o Any compliance certification recognized by accrediting organization.</p> <ul> <li>Skills/Knowledge/Abilities: Decision-making skills. </li></ul> <p>PHYSICAL REQUIREMENTS</p> <ul> <li>Majority of time involves sitting or standing; occasional walking, bending, and stooping. </li><li>Long periods of computer time or at workstation. </li><li>Light work that may include lifting or moving objects up to 20 pounds with or without assistance. </li><li>May be exposed to inside environments with varied temperatures, air quality, lighting and/or low to moderate noise. </li><li>Communicating with others to exchange information. </li><li>Visual acuity and hand-eye coordination to perform tasks. </li><li>Workspace may vary </li><li>May require travel to various facilities within and beyond county perimeter; may require use of personal vehicle. </li></ul> <p>Benefits</p> <p>ABOUT HEALTH FIRST</p> <p>At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.</p>