Healthcare Compliance Audit Analyst

Neighborhood Health Plan of Rhode Island; Smithfield (RI); On-site; USD 75,000 - 110,000; Full time

Job summary

Neighborhood Health Plan of Rhode Island is seeking a Compliance Audit Specialist to participate in audits of internal departments, evaluate controls, and identify gaps requiring corrective actions. Under the Manager of Compliance Audit, you will assist in developing audit reports, annual plans, and standard methodologies to strengthen regulatory adherence.

This role requires knowledge of Medicare/Medicaid regulations, auditing or QA experience, and strong writing skills.

Qualifications

• Bachelor degree in business, health administration or equivalent.
• Minimum 2+ years of experience in the field of compliance.
• Knowledge of Medicare/Medicaid regulatory requirements.
• Experience with auditing, monitoring or quality assurance.
• Strong writing and business report writing skills.

Responsibilities

• Participate in compliance audits to evaluate controls and adherence with applicable regulatory and contractual requirements.
• Under the direction of the Manager, identify and classify gaps as findings and observations, and determine corrective actions necessary.
• Review and assess policies, procedures, and transaction samples to determine compliance with applicable regulatory and contractual requirements.
• Track the status of audits and related deliverables.
• Assist the Manager in the development of audit reports.
• Assist the Manager in the development of an annual audit plan.
• Assist the Manager in the development of a standard audit methodology.
• Performs other duties as assigned.

Skills

Writing skills

Business report writing

Analytical thinking

Auditing experience

Independent work

Education

Bachelor degree in business or health administration or equivalent

Tools

Microsoft Office (Word, Excel, PowerPoint, Project, Outlook)

Job description

Neighborhood Health Plan of Rhode Island is seeking a Compliance Audit Specialist to participate in audits of internal departments, evaluate controls, and identify gaps requiring corrective actions. Under the Manager of Compliance Audit, you will assist in developing audit reports, annual plans, and standard methodologies to strengthen regulatory adherence.

This role requires knowledge of Medicare/Medicaid regulations, auditing or QA experience, and strong writing skills.