Audit and Compliance Analyst

Providence; Beaverton (OR); Remote; USD 70,000 - 90,000; Full time

Job summary

Join a leading healthcare organization as an Audit and Compliance Analyst, focusing on compliance, policy development, and auditing within Health Care Services. The role offers a remote work option for residents in Oregon, Washington, or California, emphasizing a patient-focused culture and professional growth.

Benefits

Remote Work Option

Professional Growth Support

Inclusive Environment

Qualifications

• 3+ years in managed care, project management, data analysis, and procedure development.

Responsibilities

• Handle program compliance, policy development, auditing, and monitoring.
• Collaborate with Regulatory Compliance & Government Affairs department.
• Monitor activities of business partners to ensure compliance.

Skills

Data Analysis

Project Management

Regulatory Compliance

Education

Bachelor's Degree in Business Administration

Bachelor's Degree in Healthcare Administration

Job description

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Description

Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

• Handle elements of program compliance, policy development, auditing, monitoring, and report development within the Health Care Services teams including Care Management and Utilization Management.
• Work as a liaison for external delegated entities to provide operational support, auditing, and monitoring delegated functions.
• Collaborate with the Regulatory Compliance & Government Affairs department (RCGA) to evaluate state and federal regulations as they apply to Health Care Services.
• Work with Clinical Analytics and Information Systems teams to develop, review, and validate audit reports.
• Assist teams with review and interpretation of regulatory guidance, policy, and procedure development.
• Monitor and oversee activities of business partners and delegates to ensure compliance with regulatory requirements, accreditation standards (NCQA), and client SLAs.

Providence offers a remote work option for residents in Oregon, Washington, or California.

Qualifications:

• Bachelor's Degree in Business Administration, Healthcare Administration, or related field, or equivalent experience.
• 3+ years in managed care, project management, data analysis, and procedure development.
• Experience with regulatory compliance in Medicare, Medicaid, or Commercial lines.

Preferred: Experience with CMS and State Medicaid regulations.

Why Join Providence? Our benefits support your well-being, professional growth, and financial security. We are committed to caring for everyone, especially the vulnerable, with an inclusive and respectful environment.