Compliance External Audits

Now hiring a Compliance External Audits!

Presbyterian is seeking a Compliance External Audits that will support the Compliance Manager for External Audits in managing and tracking external audits from clients and regulators or their delegated audit firm. Respond timely and effectively to the external clients and audit agencies as required in the performance of audit response for the Presbyterian Health Plan and Fluent Health. Organize the audit functions and the individual audits. Organize audit deliverables identify responsible owners project manage the audits. Work effectively with each of the applicable lineofbusiness Compliance Managers and the PHP leadership in the audit processes. Escalate issues early in the audit process. Once a final report is issued the External Audit Compliance Analyst will work with the External Audit Compliance Manager in creating applicable remediation plans on any audit findings and observations for management of the applicable remediations through closure.

How you belong matters here.

We value our employees differences and find strength in the diversity of our team and community.

At Presbyterian its not just what we do that matters. Its how we do it and it starts with our incredible team. From Information Technology to Food Services and beyond our nonclinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time Exempt: Yes
• Job is based at Rev Hugh Cooper Admin Center
• Remote work from home: this job is intended to be conducting in the state of New Mexico.
• Work hours: Weekday Schedule MondayFriday
• Benefits: We offer a wide range of benefits including medical wellness program vision dental paid time off retirement and more for FT employees.
• Remote: Open to remote applicants in the United States except for the following states: Wyoming North Dakota Ohio California New York Iowa and Illinois

Ideal Candidate:

Bachelors degree in health care management accounting finance or related field 6 years of additional experience can be substituted in lieu of degree.
3 years in compliance healthcare management auditing or law/regulations.
Health care management accounting finance or related field.
Managed care health plan experience in Medicare or Medicaid or Commercial required.

• Bachelors degree in health care management accounting finance or related field 6 years of additional experience can be substituted in lieu of degree.
• 3 years in compliance healthcare management auditing or law/regulations.
• Health care management accounting finance or related field.
• Managed care health plan experience in Medicare or Medicaid or Commercial required.
• CHCCertified in Healthcare Compliance from HCA Healthcare Compliance Association or SCCE Society of Corporate Compliance and Ethics or be obtained within 12 months of hire date.
• Desired skillsMS Office skills e.g. Calendar Word Excel PowerPoint. SharePoint Adobe Pro PEL DART Archer.
• Desired skillsTechnical writing Claims processing applications Care Coordination systems Market Prominence or other enrollment systems.
• Ability to handle multiple projects and deadlines simultaneously.
• Ability to learn new information and skills quickly use external secure ftp sites excellent time management skills critical thinking analytical skills and problem solving demonstrates professionalism communicate effectively.

Education Essential:Bachelor Degree

• Project manage and plan and execute external audits from beginning to the end.
• Assess potential risks and controls.
• Discuss audit findings and work on special projects.
• Organize audit deliverables identify responsible owners set up audit kickoff meetings internal and external.
• Set up the data gathering sites for associated audit inputs audit submission materials gather and deliver audit materials to the auditors.
• Track and manage the external audits utilize the GRC platform to track audit status and submissions create reporting on audit progress and audit status.
• Direct fieldwork for audit efficiency and inform External Audit Compliance Manager of audit status to manage staff performance
• Coordinate followup audits and reviews based on results of prior audit recommendations.
• Gather evidence to support conclusions for higher risk areas according to established department guidelines and industry standards.
• Coordinate with the lineofbusiness Compliance Managers in evaluating the adequacy of management actions taken to mitigate audit findings and risks identified in the audit reports.
• Work in partnership with the External Audit Compliance Manager in reporting results of followup audits to leadership.
• Solves complex problems; takes a new perspective on existing solutions. Works independently; receives minimal guidance.
• Uses best practices and knowledge of internal or external business issues to improve services or processes.
• Create and develop presentations to be presented to various audiences.
• Responsible for direct communication and coordination with departmental compliance liaisons and audit responsible owners.
• Model CARES Behavior and is committed to organizational Promise and Strategy
• Other duties as assigned

All benefitseligible Presbyterian employees receive a comprehensive benefits package that includes medical dental vision shortterm and longterm disability group term life insurance and other optional voluntary benefits.

Wellness
Presbyterians Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your wellbeing. Earn gift cards and more by taking an active role in our personal wellbeing by participating in wellness activities like wellness challenges webinar preventive screening and more.

Why work at Presbyterian
As an organization we are committed to improving the health of our communities. From hosting growers markets to partnering with local communities Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients members and the communities we serve. We are locally owned notforprofit healthcare system of nine hospitals a statewide health plan and a growing multispecialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 14000 employees including more than 1600 providers and nearly 4700 nurses.

Our health plan serves more than 580000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drugfree and tobaccofree employer with smoke free campuses.