Field Medical Director, MSK Surgery
Evolent
Compliance Auditor
MTM, Inc.
full-time
Posted on:
Origin: • 🇺🇸 United States • California, Florida, Missouri
Visit company websiteSalary
💰 $47,920 - $71,880 per year
Job Level
JuniorMid-Level
About the role
- Plan and implement effective audit processes for both internal and external audits
- Facilitate remote and on-site external audits
- Interpret contract requirements and communicate expectations to needed internal stakeholders
- Support in the development and utilization of internal controls to ensure continuous compliance
- Help implement risk management strategies for the organization(s)
- Utilize the selected tracking method to record audit investigations, documentation, results, and recommendations
- Compile quarterly, and upon request, summaries of audit investigations, findings, and resolutions
- Continuously promote process improvement and process integrity throughout the organization(s) while partnering with other departments to develop practical solutions
- Assist and guide process owners in the assessment of processes for improvement and standardization opportunities, while minimizing rework, reducing cost, and improving quality output
- Assist with the creation, review, and update of MTM policies and procedures to ensure thorough and pertinent documentation; oversee MTM (and affiliates) policies, procedures, manuals, and processes to ensure contractual compliance and process efficiency
- Act as a liaison between MTM and/or affiliates and external auditors
- Report compliance concerns to the Compliance Officer, Director of Compliance and Audit and other executive staff as indicated
- Prepare for external audits by completing audit tools, compiling supporting documentation for audit sample, and referencing policies, procedures, and contracts to validate compliance
- Conduct monitoring, reporting, and follow-up on all Corrective Action Plans
- Apply policies/procedures and client contract obligations to designated audits
- Create relevant workflows, audit tools, and tracking mechanisms as assigned
- Provide any needed support to ensure ongoing compliance with URAC standards
- Assist in developing audit reports and presenting findings and recommendations to leadership, as needed
- As needed, conduct quality improvement projects for the Quality Improvement Program
- Assist with the development and execution of compliance program activities and projects as assigned
Requirements
- High School Diploma or G.E.D.
- Bachelor’s Degree or equivalent experience in compliance
- At least 2 years’ experience in an Auditor/Compliance role
- Experience working with MCO contracts or other state clients, monitoring contract and regulatory compliance
- Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint, SharePoint)
- Strong project management
- Excellent interpersonal and communication skills
- Ability to work under pressure and independently and also collaboratively with others to achieve defined goals
- High level of emotional intelligence
