Strategic Compliance & Integrity Analyst

Mnscha; Medford (MN); Hybrid; USD 72,000 - 100,000; Full time

Benefits offered by this job

Comprehensive benefits

Work-life flexibility

Predictable pay growth

Job summary

South Country Health Alliance in Minnesota seeks a Compliance and Program Integrity Analyst to help implement the Compliance Program, monitor regulatory compliance, ensure data integrity, and support investigations across claims data.

You will analyze data, prepare reports, and assist with policy management, training, and regulatory submissions while collaborating across departments in a hybrid work environment.

Qualifications

• Bachelor's degree with at least two years of experience in healthcare compliance, program integrity, investigations, or fraud detection; 5+ years of experience in lieu of degree.
• Experience analyzing healthcare claims data or supporting fraud, waste, and abuse investigations preferred.
• Excellent organization and data accuracy, reporting, and Excel skills to support compliance activities.

Responsibilities

• Monitor the organization’s compliance program with applicable state and federal rules and regulations.
• Analyze claim data and utilize fraud detection platforms to identify aberrant billing patterns and indicators of fraud.
• Participate in investigations of potential fraud and abuse and document findings in the compliance system.
• Coordinate and assist with the completion of compliance reports for regulators and internal stakeholders.
• Support education programs addressing compliance and assist with policy reviews and updates.

Skills

Data analytics

Excel

SharePoint

Communication skills

Attention to detail

Problem solving

Regulatory knowledge

Education

Bachelor's degree in healthcare compliance

Tools

Microsoft Office

Job description

South Country Health Alliance in Minnesota seeks a Compliance and Program Integrity Analyst to help implement the Compliance Program, monitor regulatory compliance, ensure data integrity, and support investigations across claims data.

You will analyze data, prepare reports, and assist with policy management, training, and regulatory submissions while collaborating across departments in a hybrid work environment.