Location: Must live within 50 miles of an Elevance Health Pulse Point office.
Responsible for facilitating multiple, complex regulatory audits. The applicant will have skills necessary to ensure accuracy of data submission, quality control of data reviewed, presentation of selected samples and remediation of any deficiencies identified.
How you will make an impact:
In addition to management of audit activity, this individual would also be responsible for quality review of various regulatory reports and management of compliance related Risk or identified Issues.
Analyzes and designs solutions to address complex and varied business needs. Consults with business partners concerning all regulatory activity.
Minimum Requirements:
Requires a BA/BS and minimum of 8 years business analysis experience, which should include analysis and project management; or any combination of education and experience which would provide an equivalent background.
Knowledge of systems capabilities and business operations is strongly preferred.
Preferred Qualifications:
Background with Prior Authorization, Medicaid line of business is also preferred.
