Compliance Auditor

What will your job look like?

The Compliance Auditor will be responsible for facilitating Client audits and supporting internal compliance operations. The Compliance Auditor may be responsible for fielding questions throughout Client audits, representing MTM in a professional and positive manner and interpret contract requirements as it relates to MTM’s operational procedures, compliance with state and federal regulations and contract compliance. The Compliance Auditor will oversee policies and procedures, provide needed support during the URAC accreditation process, and manage other projects, as required.

Location : Hybrid / Remote if located within 40 miles of an MTM office.

What you’ll do :

Plan and implement effective audit processes for both internal and external audits

Facilitate remote and on-site external audits

Interpret contract requirements and communicate expectations to needed internal stakeholders

Support in the development and utilization of internal controls to ensure continuous compliance

Help implement risk management strategies for the organization(s)

Utilize the selected tracking method to record audit investigations, documentation, results, and recommendations

Compile quarterly, and upon request, summaries of audit investigations, findings, and resolutions

Continuously promote process improvement and process integrity throughout the organization(s) while partnering with other departments to develop practical solutions

Assist and guide process owners in the assessment of processes for improvement and standardization opportunities, while minimizing rework, reducing cost, and improving quality output

Assist with the creation, review, and update of MTM policies and procedures to ensure thorough and pertinent documentation; oversee MTM (and affiliates) policies, procedures, manuals, and processes to ensure contractual compliance and process efficiency

Act as a liaison between MTM and / or affiliates and external auditors

Report compliance concerns to the Compliance Officer, Director of Compliance and Audit and other executive staff as indicated

Prepare for external audits by completing audit tools, compiling supporting documentation for audit sample, and referencing policies, procedures, and contracts to validate compliance

Conduct monitoring, reporting, and follow-up on all Corrective Action Plans

Apply policies / procedures and client contract obligations to designated audits

Create relevant workflows, audit tools, and tracking mechanisms as assigned

Provide any needed support to ensure ongoing compliance with URAC standards

Assist in developing audit reports and presenting findings and recommendations to leadership, as needed

As needed, conduct quality improvement projects for the Quality Improvement Program

Assist with the development and execution of compliance program activities and projects as assigned

What you’ll need :

High School Diploma or G.E.D.

Bachelor’s Degree or equivalent experience in compliance

At least 2 years’ experience in an Auditor / Compliance role

Experience working with MCO contracts or other state clients, monitoring contract and regulatory compliance

Must possess the ability to assess potential problems and make sound judgments around issues that may have an adverse effect on the business

Detail-oriented, thorough, and a systematic / methodical approach to projects

Strong project management

Ability to present complex information in a simple and compelling manner

Ability to multi-task, set priorities and meet deadlines

Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint, SharePoint)

Strong people management skills

High level of emotional intelligence

Excellent interpersonal skills

Ability to work well under pressure

Ability to work independently and also collaboratively with others to achieve defined goals

Excellent written and oral communication skills

Outstanding analytical and organizational skills

Ability to maintain high level of confidentiality

Regular attendance is required

Ability to identify areas of improvement and provide recommendations

Even better if you have...

Previous experience in Medicaid or state public assistance programs preferred

Experience working for a managed care organization or healthcare provider preferred

What’s in it for you :

Health and Life Insurance Plans

Dental and Vision Plans

401(k) with a company match

Paid Time Off and Holiday Pay

Maternity / Paternity Leave

Casual Dress Environment

Tuition Reimbursement

MTM Perks Discount Program

Leadership Mentoring Opportunities

Salary Min : $47,920

Salary Max : $71,880