Healthcare Business Analyst

Yugal Tech Academy; Chicago (IL); On-site; USD 85,000 - 120,000; Full time

Job summary

A healthcare compliance organization is seeking a Business Analyst for a pivotal role supporting the Medicare Compliance Officer. This position involves managing compliance programs, conducting audits, and ensuring readiness for compliance. The ideal candidate has at least seven years in the health payer industry, with a preference for experience in Medicare Programs and strong auditing skills. This role requires on-site presence in Chicago and includes tracking compliance training and managing communications.

Qualifications

• Minimum 7 years’ experience in the health payer industry.
• Experience with Medicare Program Audits or Medicare CPE Audits is desirable.
• Experience in compliance programs is preferred.

Responsibilities

• Track compliance training and auditing activities.
• Manage compliance program communications and meetings.
• Assist with audit readiness for compliance programs.
• Assists with audit readiness and policy updates.

Skills

Medicare Programs experience

Compliance Program management

Health payer industry knowledge

Auditing skills

Job description

This position will require being on-site 1 day a week, in either the Chicago or Washington, DC office. This position will support the Part D Medicare Compliance Officer. Preference will be given to candidates with experience in Medicare Programs. Designs and documents business process requirements for all related business, financial, and operational systems critical to core business functions within FEP for support of the Medicare Prescription Drug Program, and other Medicare programs. This may require the Business Analyst to research and analyze data in support of business functions, process knowledge, and systems requirements. Recommends new or improvements to existing business and operational processes and procedures. Manages projects to build a Medicare Compliance Program. Manages compliance program auditing and monitoring activities. Assists with audit readiness. This person should have 7 years’ experience in the health payer industry – Blues or FEHBP experience desirable. Experience in Medicare Program Audits or Medicare CPE Audits is desirable. Experience with Compliance Programs is preferred.

Key Responsibilities

• compliance training tracking
• auditing and monitoring compliance program
• monthly exclusion check monitoring
• updating policies and procedures
• compliance hotline monitoring
• compliance program communications
• compliance committee meetings
• compliance program workplan
• HPMS memo review and analysis
• compliance program liaison with FEP
• Medicare Compliance shared mailbox owner
• attend monthly MAPD Plan calls
• assist with Compliance Program audit readiness

Ability to Commute:

• North Chicago, IL 60064 (Required)

Ability to Relocate:

• North Chicago, IL 60064: Relocate before starting work (Preferred)