Remote
eHealthInsurance Services Inc.

Compliance Analyst

Legal

Remote, United States

The Medicare Compliance Analyst will report to the Compliance Manager and will assist with the implementation of the Medicare Compliance Program including but not limited to audit and monitoring initiatives and reviewing marketing materials.

Responsibilities

  • Assist with the development of an internal risk assessment and audit work plan.
  • With supervision from the Medicare Compliance Manager, execute internal and external audits as approved by the Compliance Committee.
  • Draft comprehensive and complete audit reports including any findings and recommendation for business areas and assist business areas with the development, implementation and monitoring of effective corrective action plans.
  • Timely respond to external audit and attestation requests, document results within established repository in accordance with defined departmental policies and procedures, and report audit results and corrective actions to the Medicare Compliance Manager and Medicare Compliance Officer.
  • Participate in conference calls with eHealth Clients to discuss audit results to foster a strong partnership with the client.
  • Evaluate eHealth policies and procedures and report findings to the Medicare Compliance Manager to promote adherence to CMS regulations.
  • Assist in the communication of internal and external audit results from eHealth Clients to applicable stakeholders and coordinate any follow-up requested.
  • Maintain working knowledge of all applicable Centers for Medicare & Medicaid Services (CMS) regulatory guidance with the ability to interpret and communicate to others in layman’s terms.
  • Works with business units to increase awareness of the importance of the compliance, FWA plans and the Code of Conduct.
  • Review marketing materials, scripts, etc. for compliance with CMS regulations and communicate compliance concerns to internal departments.

Basic Qualifications

  • 4+ years experience at a Medicare Advantage Organization or Prescription Drug plan Sponsor

Preferred Qualifications

  • BA/BS Degree
  • Must be detail oriented with good organizational, written and verbal communication skills.
  • Ability to work in a fast paced environment and effectively prioritize work to meet internal and external deadlines.
  • Proficiency in Microsoft applications (Word, Excel, PowerPoint and Outlook).