Provider Data Quality & Compliance Auditor

EmblemHealth; New York (NY); On-site; USD 49,000 - 83,000; Full time

Job summary

EmblemHealth in New York seeks an Auditor to perform vendor performance audits and support provider data integrity across core processes. You will ensure adherence to contracts, regulatory expectations, and customer experience standards through routine audits, data analysis, and follow-up.

Responsibilities include conducting routine audits, documenting results, escalating trends, maintaining records, and contributing to cross-functional projects.

Qualifications

• Bachelor's degree required.
• 2-3+ years of auditing/assessment experience required.
• Strong collaboration and stakeholder communication skills required.
• Auditing skills applicable to various business problems.
• Excellent verbal, written, and presentation skills across audiences.
• Ability to manage multiple tasks/projects simultaneously.
• Experience with Provider Files or equivalent preferred.
• Proficiency in MS Office (Word, Excel, Access, PowerPoint, Outlook, Teams, SharePoint).

Responsibilities

• Audit vendor performance across core processes to ensure contractual requirements and customer experience objectives are met.
• Perform routine transactional reviews, audits, and compliance checks; document results and escalated trends to leadership.
• Investigate root causes, coordinate with partners and vendors, and document outcomes; escalate high-risk issues and suggest improvements.
• Maintain audit records; document findings, variances, and evidence; escalate results to management for corrective actions.
• Contribute to project activities and share knowledge within teams and workgroups.
• Share process knowledge and best practices with peers and new team members.

Skills

Auditing

Communication

Collaboration

Project management

Education

Bachelor's degree

Tools

MS Office

Job description

EmblemHealth in New York seeks an Auditor to perform vendor performance audits and support provider data integrity across core processes. You will ensure adherence to contracts, regulatory expectations, and customer experience standards through routine audits, data analysis, and follow-up.

Responsibilities include conducting routine audits, documenting results, escalating trends, maintaining records, and contributing to cross-functional projects.