Senior Compliance Auditor & Risk Advisor

Louisiana Blue; Baton Rouge (LA); On-site; USD 90,000 - 120,000; Full time

Job summary

Louisiana Blue is seeking a Compliance/Audit professional to perform internal audits and ensure adherence to state and federal regulations within the healthcare sector. The role involves reviewing procedures, advising management, and coordinating with external regulators.

The ideal candidate has 4+ years in compliance or audit, with knowledge of Medicare/Medicaid and URAC/NCQA standards. Residency in Louisiana is preferred, and the position requires strong communication and confidentiality.

Qualifications

• Bachelor's in Business Administration, Health Administration or a related field as deemed necessary by department management required
• Master's in related field preferred
• Four years of related experience can be used in lieu of a Bachelor’s degree.
• Must have a minimum of 4 years of experience in a predominantly audit and analytical position related to compliance or audit.
• Experience in Medicare Advantage/Medicaid/commercial or health care reform compliance is required.

Responsibilities

• Conduct audits, reviews, evaluations and special reviews to determine compliance with laws and regulations.
• Stay current with State and Federal laws and regulations relevant to Code of Business Conduct and Compliance program.
• Advise management on changes and ensure assigned areas track applicable laws in databases.
• Lead or assist external audits and special projects as assigned.
• Provide compliance guidance to various levels of personnel and act as SME when needed.

Skills

Communication skills

Analytical ability

Time management

Confidentiality

Travel willingness

Software knowledge

Education

Bachelor's in Business Administration/Health Administration

Master's preferred

Four years of related experience can substitute degree

Job description

Louisiana Blue is seeking a Compliance/Audit professional to perform internal audits and ensure adherence to state and federal regulations within the healthcare sector. The role involves reviewing procedures, advising management, and coordinating with external regulators.

The ideal candidate has 4+ years in compliance or audit, with knowledge of Medicare/Medicaid and URAC/NCQA standards. Residency in Louisiana is preferred, and the position requires strong communication and confidentiality.