About this role
McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Compliance Audit Analyst, to join in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary:
Responsible for identification, analysis, and performance of compliance audits in all lines of business, consistent with State, Federal, and Health Plan policies, regulations, and contractual requirements, not limited to, detect, prevent, and respond to potential instances of non-compliance. Responsible for supporting all aspects of the Compliance Program. Performs quality assurance activities on analytics for all product lines to identify non-compliance with regulations and procedures. Analyzes, reviews, and presents information on audit outcomes to support business decisions.
This position is fully remote.
Qualifications:
Required:
- Associate Degree in business, health care or related field.
- Two (2) years of progressively more responsible position using auditing and/or analytical skills.
Preferred:
- Bachelor’s Degree in business, health care or related field.
- Two (2) years of compliance or related experience in health care or related field.
- Two (2) years’ experience and knowledge of HMO, or PPO Course work or work experience in statistics.
Other facts
About McLaren Health Care
McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 28,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.
As part of its Graduate Medical Education (GME) program, McLaren maintains academic affiliations with medical schools at Wayne State University, Michigan State University and Central Medical University. McLaren’s seven (7) GME campuses offer 27 residencies and eight (8) fellowship programs that train over 650 future physicians annually. All GME programs at McLaren are overseen and managed centrally by the Department of Academic Affairs.
What you'll do
- Responsible for identification, analysis, and performance of compliance audits across all lines of business. Supports all aspects of the Compliance Program and performs quality assurance activities to identify non-compliance with regulations.
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