AUDITOR

Description

Job description

• Responsible for documenting individual complaints and / or incidents, coordinating resolutions, tracking data, and generating reports for senior management and the Incident Review committee.
• Maintain documentation of all reportable incidents and generating summary reports for the Incident Review Committee. Regularly conduct reviews and assessments of complaints and incidents, and maintain a detailed database of these instances.
• Identifying opportunities for process improvement and report automation.
• Assisting with Part 511 policy maintenance.
• Maintain all Part 511 related risk management files including sensitive and confidential. This involves the coordination of paperwork and supporting documentation from programs. Ensure timeliness of data and submit documentation to regulatory agencies as necessary.
• Responsible for routine medical and clinical record reviews utilizing a standardized assessment tool to monitor compliance with record requirements and protocols as well as evidence-based clinical guidelines and protocols.
• Responsible for gathering evidence of Compliance controls within the Managed Care Program to assess their design performance. Collate results into a report for the Chief Compliance Officer.
• Responsible for generating and measuring quality improvement initiatives.
• Attend trainings, workshops, or conferences to remain current with the position requirements.
• Participation in meetings and on committees as needed
• Assumes responsibility to manage and reduce risk where it is seen in his or her area(s) of responsibility and to report it if it outside of his or her area(s) of responsibility or assistance is needed to resolve the matter.
• Adheres to agency policies and procedures; follows and supports agency mission, vision and values including participating in internal surveys and data collection for continuous improvement initiatives.
• Perform other duties as assigned.

Job Requirements

Together for Youth is an equal opportunity employer and does not discriminate on the basis of age, race, creed, color, national origin, sexual orientation, military status, sex, pregnancy, gender identity or expression, disability, marital status, or any other basis covered by appropriate law.

We are committed to fostering an inclusive, equitable, and accessible environment where diversity is valued and recognized as a source of strength and enrichment. We seek to attract talented people from a diverse range of backgrounds and cultures.

As a federal contractor, Together for Youth will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c)

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