Compliance Operations Analyst
Posted on: November 22, 2021
Your career starts now. We're looking for the next generation of
health care leaders.At AmeriHealth Caritas, we're passionate about
helping people get care, stay well and build healthy communities.
As one of the nation's leaders in health care solutions, we offer
our associates the opportunity to impact the lives of millions of
people through our national footprint of products, services and
award-winning programs. AmeriHealth Caritas is seeking talented,
passionate individuals to join our team. Together we can build
healthier communities. If you want to make a difference, we'd like
to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas
is a mission-driven organization with more than 30 years of
experience. We deliver comprehensive, outcomes-driven care to those
who need it most. We offer integrated managed care products,
pharmaceutical benefit management and specialty pharmacy services,
behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.This role is
eligible for a $3,000 sign-on bonusResponsibilities:The Compliance
Operations Analyst will assist the Director of Compliance for
AmeriHealth Caritas Next, a Federally Qualified Health Plan (FQHP)
located in North Carolina, in establishing and maintaining
compliance with all applicable requirements and obligations,
including state and federal rules, regulations, standards, and
Marketplace requirements, and in maintaining and observing the
highest standards of ethical conduct in the Plan's business and
operational practices.In addition, this position includes the
following specific job duties (which should be considered a
- Supports oversight of the FQHP's compliance with program
- Supports the Plan in implementing policies, procedures, and
practices designed to ensure compliance with the requirements of
- Assists with Investigating, documenting, tracking and
responding to compliance issues, and enforcing corrective actions
in order to address offenses and working on specific
compliance-related projects as designated by the Compliance
- Assists in the development and implementation of compliance
policy, procedures, and process and control activities.
- Assists with development of compliance methodologies to test
established and newly executed operational processes and controls
and monitor effectiveness.
- Assists with developing and monitoring compliance training and
- Assists the Director of Compliance with conducting ad-hoc
compliance assessments/research as requested, and ensures that
local compliance related issues and risks are identified,
aggregated, and reported.
- Assists with coordinating internal and external audit
activities, and helps ensure responses to audit findings or
conclusions are properly implemented by business process owners in
a timely manner.
- Supports the Compliance Officer in preparing for FQHP
Compliance Committee meetings, including ensuring that all required
compliance committee meetings are scheduled, held, and minutes
taken of the same.Education/Experience:
- Bachelor's Degree.
- Strong research, writing and interpersonal skills.
- Strong oral and written communication skills.
- Strong facilitation, collaboration and teamwork skills with the
ability to build cross-functional partnerships to drive
- Strong interpersonal skills.
- Innovative and creative. Able to embrace change and think
outside the box.
- Strong problem solving and critical thinking skills.
- Strong analytical and research skills, able to synthesize
information to provide practical solutions to accomplish meaningful
- Strong organizational skills, with the ability to apply good
judgment and resolve ambiguities.
- Demonstrated knowledge of compliance concepts and practices
(strategies, control activities, information analysis and reporting
- Self-motivated with demonstrated project management
- Acts independently and requires minimal supervision.
- Demonstrates a general understanding of operational processes
and controls and monitors the execution of operational changes
required by regulations and guidelines associated with FQHPs.
- Proactive, can-do attitude and work ethic
- Strong analytic skills, with ability to identify process gaps,
weaknesses and deficiencies and/or business productivity/efficiency
- Knowledge of governmental and/or health plan products (MAO,
MCO, etc.) with preference of evidenced FQHP compliance operations
experience.Back ShareApply Now
Keywords: Amerihealth, Raleigh , Compliance Operations Analyst, Professions , Raleigh, North Carolina
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