Compliance Auditor

What will your job look like?

The Compliance Auditor will be responsible for facilitating Client audits and supporting internal compliance operations.  The Compliance Auditor may be responsible for fielding questions throughout Client audits, representing MTM in a professional and positive manner and interpret contract requirements as it relates to MTM’s operational procedures, compliance with state and federal regulations and contract compliance. The Compliance Auditor will oversee policies and procedures, provide needed support during the URAC accreditation process, and manage other projects, as required.

Location: Hybrid/Remote if located within 40 miles of an MTM office.

What you’ll do:

• 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

What you’ll need:

Experience, Education & Certifications:

• High School Diploma or G.E.D.

• Bachelor’s Degree or equivalent experience in compliance

• At least 2 years’ experience in an Compliance/Auditor role

• Experience monitoring contract and regulatory compliance, required.  Experience working with MCO contracts or other state clients strongly preferred

Skills:

• Must possess the ability to assess potential problems and make sound judgments around issues that may have an adverse effect on the business

• Detail-oriented, thorough, and a systematic/methodical approach to projects

• Strong project management

• Ability to present complex information in a simple and compelling manner

• Ability to multi-task, set priorities and meet deadlines

• Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint, SharePoint)

• Strong people management skills

• High level of emotional intelligence

• Excellent interpersonal skills

• Ability to work well under pressure

• Ability to work independently and also collaboratively with others to achieve defined goals

• Excellent written and oral communication skills

• Outstanding analytical and organizational skills

• Ability to maintain high level of confidentiality

• Regular attendance is required

• Ability to identify areas of improvement and provide recommendations