Operations Auditor

This is a fully remote position, open to applicants in Kansas.

📋 Description

• Conduct audits on system entries, performance metrics, and operational processes for designated functions.

• Assess the accuracy of new group setups, modifications to existing contracts, and terminations of groups.

• Develop, implement, and oversee data review procedures for PDM/Credentialing data reports.

• Carry out risk-based audits to evaluate controls and processes for scalability, efficiency, and risk mitigation.

• Compile audit findings and present them to management along with recommendations for enhancements in operations, systems, and procedures.

• Ensure that established goals are met and that supporting documentation is available to assess performance.

• Coordinate the outcomes of audits to create and disseminate corrective actions and educational resources related to audit discrepancies.

• Analyze and assess information systems and suggest controls to ensure system reliability and data integrity.

• Identify and address system issues pertaining to data loads.

• Investigate state contract requirements and standards from accrediting bodies to pinpoint potential risks.

• Perform additional assigned tasks while adhering to policies and standards.

⛳️ Requirements

• Bachelor’s degree in a relevant field, or equivalent experience.

• Over 3 years of experience in auditing or process improvement.

• Familiarity with state contract and accreditation requirements.

• Experience in a managed care setting is preferred.

• Background in LTSS, Home- and Community-Based Services, case management, managed care, HEDIS, or KDADS-related audit activities is preferred.

• Previous experience in auditing case files, reviewing documentation, identifying trends, and suggesting process improvements is preferred.

• Strong attention to detail, exceptional organizational skills, and effective time management abilities.

• Capability to work independently in a remote setting.

🏝️ Benefits

• Competitive compensation.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

• Flexible working arrangements, including remote, hybrid, field, or office schedules.