Demo

Healthcare Business Analyst

adroitts
North Chicago, IL Full Time
POSTED ON 1/28/2025
AVAILABLE BEFORE 3/28/2025

This position will require being on-site 1 day a week, in either the Chicago or Washington, DC office. This position will support the Part D Medicare Compliance Officer. Preference will be given to candidates with experience in Medicare Programs. Designs and documents business process requirements for all related business, financial, and operational systems critical to core business functions within FEP for support of the Medicare Prescription Drug Program, and other Medicare programs. This may require the Business Analyst to research and analyze data in support of business functions, process knowledge, and systems requirements. Recommends new or improvements to existing business and operational processes and procedures. Manages projects to build a Medicare Compliance Program. Manages compliance program auditing and monitoring activities. Assists with audit readiness. This person should have 7 years’ experience in the health payer industry – Blues or FEHBP experience desirable. Experience in Medicare Program Audits or Medicare CPE Audits is desirable. Experience with Compliance Programs is preferred.

Deliverable:

· compliance training tracking

· auditing and monitoring compliance program

· monthly exclusion check monitoring

· updating policies and procedures

· drafting SOPs

· compliance hotline monitoring

· compliance program communications

· compliance committee meetings

· sharepoint folder

· compliance program workplan

· HPMS memo review and analysis

· compliance program liaison with FEP

· Medicare Compliance shared mailbox owner

· attend monthly MAPD Plan calls

· Part CD ListServ owner

· assist with Compliance Program audit readiness

Job Type: Contract

Pay: Up to $65.00 per hour

Ability to Commute:

  • North Chicago, IL 60064 (Required)

Ability to Relocate:

  • North Chicago, IL 60064: Relocate before starting work (Preferred)

Work Location: In person

Salary : $65

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