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The Senior Compliance Analyst is part of the Audit and Corrections team will be responsible for facilitating health plan and regulatory audits, as well as related corrective action plan (“CAP”) activities and will report to the Compliance Director, Correction. This individual will be responsible for driving best practices across the company to promote compliance with audit and correction processes. This role is part of the Avesis Compliance Department.

The Compliance Department plays a pivotal role in ensuring that Avēsis adheres to federal and state regulations, as well as internal policies. It is responsible for preventing, detecting, and correcting compliance risks that could impact the Avesis’ operational effectiveness as well as legal and reputational standing. The Compliance Department works to promote a culture of ethics, transparency, and accountability across the enterprise, making sure that all employees understand their responsibilities and the importance of adhering to legal, regulatory and compliance standards. Additionally, it provides ongoing training and resources to help staff stay informed about regulatory updates and best practices.

The Senior Compliance Analyst will be primarily responsible for managing health plan and regulatory audit activity including, but not limited to, audit deliverable coordination, on-site audit coordination and management, and mock audit activities.  The individual will also manage the corrective action process for health plan and regulatory CAPs. This role requires collaboration with stakeholders at all levels of the organization; therefore, candidates should demonstrate skillful communication, flexibility, and conflict resolution skills.  It is a telecommuter role and an individual contributor with minimal travel.

Competencies:

Functional:

• Coordinate all aspects of regulatory and client audits (i.e., pre-site deliverables, mock audits, on-site visits, logistics, and written responses to audit reports and corrective actions) and coordinate across times to document and track completion to ensure audit success.
• Synthesize audit-related information (i.e., scope, findings, recommendations, corrective action plans, and status) and provide Compliance and business operations leadership written and oral reports of ongoing and completed audits
• Simultaneously manage multiple audits and collaborate across multiple business areas to communicate gather necessary information within assigned due dates
• Develop compliance communications
• Problem solve and work closely with business partners on issue resolution
• Research, understand, and articulate regulatory and contractual requirements
• Educate business partners on regulatory audit processes as needed
• Manage, track and report data related regulatory and client audits and CAPs
• Coordinate with Legal Counsel as needed
• Perform additional duties as requested or required by management

Core:

• Ability to manage time effectively and efficiently
• Ability to analyze data for accuracy
• Ability to work independently and with minimal direction
• Ability to demonstrate managing of projects
• Proficient oral and verbal communication skills
• Ability to demonstrate critical thinking skills

Behavioral:

• Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth. 
• Initiative: readiness to lead or take action to achieve goals.
• Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
• Member-focused: going above and beyond to make our members feel seen, valued, and appreciated.
• Detail-oriented and thorough: managing and completing details of assignments without too much oversight.
• Flexible and responsive:  managing new demands, changes, and situations.
• Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task.
• Integrity & responsibility:  acting with a clear sense of ownership for actions, decisions and to keep information confidential when required.
• Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.

Minimum Qualifications:

• Bachelor’s degree in business, healthcare, or re