[Hiring] Quality and Reporting Analyst @Health Care Service Corporation

Role Description

This position is responsible for auditing operations compliance with accreditation and regulatory requirements in assigned areas. Ensuring compliance with Plan, BCBSA, NCQA and State and Federal regulatory requirements.

• Researching and reporting monthly on trends.
• Preparing monthly documented summaries, receipts, and analyzing how these impact accreditation requirements.
• Recommending and implementing technical solutions (i.e. Enterprise Appeals Application requirements).
• Communicating to the management team of the need/gap.
• Gathering data, analyzing data, and preparing reports.
• Disseminating information from various sources and systems.
• Supporting projects and initiatives and resolving issues by working with staff within the department and across departments.

Qualifications

• Bachelor degree and 2 years of insurance experience OR 6 years’ insurance experience.
• Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation.
• Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges and proposing solutions.
• Knowledge or experience monitoring compliance and managing evidence documents.
• Experience preparing monthly reports and forecasting.
• Research skills.
• Analytical skills.
• Detail orientation and organizational skills; experience meeting deadlines on time.
• Ability and willingness to travel, including overnight stays.
• Clear and concise verbal and written communication skills.
• PC proficiency to include Word, Access, Excel and Cognos.

Requirements

• Experience assisting with or leading projects - highly preferred.
• 1+ years' experience in ongoing audits, relating to but not limited to healthcare and provider data.
• Ability to confidently interact with senior leaders and executives.
• Audit tools experience (PPW, Salesforce, etc.).
• Knowledge of Accreditation (i.e. NCQA, URAC, CMS, etc.).
• Professional level of MS Suite skills (MS Office, Word, PowerPoint, Excel, etc.).
• Sponsorship will not be provided for this role.
• This is a Telecommute (Remote) role.

Benefits

• Health and wellness benefits.
• 401(k) savings plan.
• Pension plan.
• Paid time off.
• Paid parental leave.
• Disability insurance.
• Supplemental life insurance.
• Employee assistance program.
• Paid holidays.
• Tuition reimbursement.
• Other incentives.