Compliance Audit Manager
Posted on: November 22, 2021
Reporting to the Director, Compliance & Privacy, the Compliance
Audit Manager is responsible for auditing and analyzing the
clinical and operational work processes, policies and procedures to
ensure compliance with all laws, regulations and guidelines with
Federal and State programs. Develops and executes monitoring and
auditing projects, to include standard, repeatable processes
identifying, documenting and presenting any errors, irregularities
or findings. Manages audit activity to include gathering documents
and data, determining and writing reports of audit findings,
identification and completion of necessary corrective action.
Partners with functional leaders and field teams to coordinate
audit and monitoring activities from initiation through completion
of corrective action. Serves as the auditor-in-charge when
necessary. Serves as a resource both internally and externally
regarding compliance-related issues, including the coordination of
payer, regulatory or other audits.
Develops and executes internal monitoring and auditing activities
in response to company risks in partnership with team members and
leaders in other functional departments and geographic locations
across the company; to include process documents, roll-out training
and communications to launch audits, status updates to audit
participants and relevant leaders, written report and presentation
of findings, development and execution of corrective action plans
and progress reports on responsive measures, and other associated
activities as needed to successfully conclude audit and monitoring
activities. Respects and maintains the confidentiality of sensitive
business and patient information at all times. Maintains files and
work papers consistent with company policy and Compliance
Department processes at all times.
Coordinates with company locations and respective leadership and
team members for responsive information, review of findings and
determination of appeal and appropriate corrective action; ensures
corrective action implementation prevents repeat claim denials;
creates and presents reports on audit findings to department and
Manages and partners with external consultants engaged to conduct
compliance audits and related activities to support successful
completion of such initiatives. Coordinates with external auditors
and company locations/departments under review to foster
understanding and provide required documentation, correspondence,
responses, appeal information or other necessary follow up as
needed related to the audit process within deadlines.
Escalates and reports serious compliance, quality or other business
risks timely to the Chief Compliance Officer and other functional
leadership by demonstrating the ability to exercise good
independent judgment in assessing the significance and relevance of
identified issues. Prepares clear, accurate and timely audit
reports and ensure that audit work meets internal auditing
Reports and presents major deficiencies and other findings to
executive management, functional leaders and organizational
Develops and implements action plans, follow up schedule and
reports in coordination with respective department leads
Identifies policy, procedure, and process gaps and partners with
functional leaders to develop responsive corrective measures to
Develops and revises compliance policy and procedures related to
auditing and monitoring activities.
Assists with the development and implementation of compliance
Develops and manages strong working relationships with other team
members and leaders within company departments and locations.
Other duties as assigned to support Compliance Department and/or
Bachelors degree in business or a healthcare related field.
Certified Healthcare Compliance (CHC) or other related
license/certification is preferred
Minimum of three years of compliance auditing in healthcare
environment, preferably in home infusion/home health setting.
Demonstrated effective communication, presentation, organizational,
and writing skills with strong attention to detail Strong computer
skills, including proficiency in Microsoft Office Suite
Working knowledge and understanding of federal and state healthcare
Skilled in problem solving and critical analysis
Skilled in developing and delivering presentations
Keywords: Hyrandes, Waukegan , Compliance Audit Manager, Accounting, Auditing , Waukegan, Illinois
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