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At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at [ Link removed ] - Click here to apply to Compliance Operations Analyst.
The primary purpose of the Compliance Operations Analyst will be to assist in developing processes to implement compliance initiatives that apply to the AmeriHealth Caritas North Carolina (ACNC) line of business. The responsibilities of this position include developing new and updating existing compliance policies and procedures, developing and monitoring corrective action plans, and working on specific compliance-related projects as designated by the ACNC Compliance Department. The analyst will also be responsible for monitoring ACNC’s compliance with the Medicaid state contracts and all applicable federal and state laws. The analyst will develop competencies to support the operational departments of AmeriHealth Caritas North Carolina in accordance with Medicaid contractual and state and federal regulatory requirements. The analyst must possess strong research, writing and interpersonal skills. The analyst will aide in the development of metrics and reports to mitigate risk, evaluate and report possible regulatory-based and/or contract-based project management office activities and aid in the collection of information to drive necessary compliance activities
Bachelor’s Degree in Business, Social Science or other relevant field preferred or the equivalent combination of education and experience.
Demonstrated competency in compliance operations.
Ability to navigate governmental resources to find information quickly and accurately.
Ability to deliver information accurately with insight and perspective.
Ability to manage multiple priorities simultaneously and consistently meet deadlines.
Ability to review and understand contractual requirements.
High technical competency and skills to learn complex information and new programs.
Ability to apply project management skills and coordinate activities involving multiple departments and resources to drive successful project completion.
Minimum of 3 years professional work experience in health care regulatory analysis or compliance, preferably in a managed care setting.
Ability to accomplish goals with minimal supervision both independently and as a team member; High attention to detail; Excellent interpersonal skills; Disposition to adapt and manage change; Demonstrated initiative; Excellent writing skills; Excellent presentation skills.
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Job ID: PGM-CC-7055_20858
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