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Centene Corporation · 4 hours ago

Senior Compliance Risk Adjustment Analyst

United States

Full-time

Remote

Mid, Senior Level

$69K/yr - $124K/yr

3+ years exp

Centene Corporation is transforming the health of communities across the United States. The Senior Compliance Risk Adjustment Analyst will support the Risk Adjustment Compliance program by focusing on auditing and monitoring functions, collaborating with business areas to address compliance issues, and facilitating external audits related to Risk Adjustment processes.

Hospital & Health Care

Responsibilities

Serves as the point of contact for external audits, and correspond with auditors related to audit acknowledgement, deliverables timelines and other inquiries

Manages external audit deliverables submission responsibilities and responds to inquiries from state and federal regulatory agencies timely

Quality Review all external audit deliverables for completeness and accuracy prior to submission to external auditors

Communicates with both internal and external audit partners to clarify deliverables, audit requirements and deadlines

Serves as a risk adjustment external audit resource and liaison on external audit policies, communications, external audit workflow, and quality improvements initiatives

Socializes identified risks with internal partners including the Compliance Corrections team by timely entering Corrective Action Intake

Supports the Corrective Action Plan development and reviews prior to submission to the external auditors

Effectively creates and communicates audit milestone progress reporting

Maintains detailed audit documentation including meeting minutes, action items, identified issues, and risk management plans

Performs other duties as assigned

Complies with all policies and standards

Qualification

Risk Adjustment ComplianceExternal AuditsAudit Deliverables ManagementRisk Adjustment/HCC CodingMedicare ExperienceAudit DocumentationCommunication SkillsCollaboration SkillsProblem-Solving SkillsAttention to DetailTime ManagementTeamworkAdaptabilityOrganizational SkillsCritical Thinking