At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is  invested in your future!

Job Summary

This position is 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 (i.e., Enterprise Appeals Application requirements) 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.



**This is a hybrid position requiring 3 days in office/ 2 days remote**

Required Job Qualifications:

• 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 skills.
• 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.

Preferred Job Qualifications:

• Audit experience.
• Salesforce and PPW Experience preferred.
• Knowledge of Accreditation (i.e., NCQA, URAC, etc.)

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.