Job Requirements
POSITION SUMMARY
The Audit Integrity Analyst ensures organizational integrity and compliance by monitoring and auditing
internal operations and vendor activities, providing recommendations to align with laws, regulations,
and policies. The Audit Integrity Analyst plans and executes audits, prepare detailed reports, and
present findings to management. The Audit Integrity Analyst stays informed on industry trends and
manages routine duties and projects with minimal supervision, seeking guidance only for complex
matters.
PRIMARY ACCOUNTABILITES
1. Collaborates to investigate, direct and resolve compliance issues through appropriate existing
channels.
2. Implements effective monitoring and auditing of appropriate compliance indicators to oversee
high-risk areas and assist in managing external audits from government entities.
3. Assists with conducting the annual risk assessment and workplan build process to identify key
areas of concern within the Health Plan Operational Teams, and applicable vendors.
4. Plans, develops, and recommends objectives, audit steps, and tools to be used in auditing and
monitoring of operational departments and vendors.
5. Identifies the types and quantity of information and evidence needed to complete assigned audit
tasks, how to efficiently obtain such information, analyze it within the context of the audit
objectives, and to formulate appropriate subsequent actions and recommendations.
6. Examines business and vendor procedures, analyzes data, verifies accounts, and inspects
operations to ensure compliance and maintain adequate controls.
7. Consistently and accurately document relevant facts and information to support the audit,
monitoring and conclusions so others can follow the logic and methodology.
8. Presents the results of audits and monitoring to appropriate management, which may include
executive leadership, by calculating outcomes, documenting findings and observations,
identifying high risk areas for further auditing, in a clear and consider manner through an
audit/monitoring report.
9. Assesses and recommends action to be taken when control, operational weaknesses, and
compliance issues are found.
10. Works with business areas to implement corrective actions and follows department processes to
ensure they are effectively executed in a timely manner.
11. Analyzes and interprets government regulations to acquire and maintain knowledge.
Work Experience
MINIMUM QUALIFICATIONS
o Proficient in Microsoft Office – Outlook, Word, Excel, PowerPoint.
o Demonstrated proficiency in understanding and analyzing federal and state health care rules and regulations, including HIPAA.
o Excellent interpersonal, written, and verbal communication skills and ability to work with all levels of health care personnel, including Executive management.
o Excellent time management, planning and organization skills, detail oriented.
o Strong critical thinking and analytical skills needed to identify key controls, business process improvements, evaluate alternatives and develop effective audit/monitoring recommendations.
o Ability to work independently with minimal supervision and exercise professional judgment regularly.
o Self-confidence and composure to handle stressful, emergent, and dynamic work situations in a team environment often while managing multiple, concurrent, high- priority tasks.
o Persistence and attention to detail to produce high-quality, professional-looking work products and to continuously improve personal performance.
o Demonstrates strong customer service skills.
PREFFERED QUALIFICATIONS
o Certified Professional Coder for Payers (CPC-P).
o Any compliance certification recognized by accrediting organization.
PHYSICAL REQUIREMENTS
Benefits
ABOUT HEALTH FIRST
At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.
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