- Drive critical data analysis through regular oversight and monitoring activities using expense data, customer master, and other fee-for-service data with an eye toward automation.
- Assist HCCOs in providing guidance and oversight on business programs, initiatives, and processes based upon insights and trends identified from monitoring activities.
- Complete special projects as identified, working across HCC and other business functions.
- Prepare and present presentations to HCC Officers highlighting monitoring trends and areas of risk.
- Contribute to Program Management oversight & monitoring efforts by serving as a liaison between HCC Officers, Compliance & Technology Integration (CTI), and Global Assessment and Consulting Services (GACS), reviewing monitoring reports, analyzing for potential issues and trends, conducting, and documenting follow-ups, recommending enhancements, and capturing insights and trends in collaboration with the HCC Officers.
- Identify and/or implement business efficiencies, technology solutions, process improvements and enhanced reporting capabilities to assist in the implementation of a sustainable HCC program.
- Assist in coordinating Risk Assessment process for the region and identifying and driving process improvements across the team. Develop and implement metrics, templates, and/or scorecards to support annual risk assessment and quarterly risk reviews.
- Provide transactional reviews of transfers of value to health care professionals and government officials, perform reviews of material, and engage with business partners to provide guidance on HCC-sensitive topics in alignment with HCC policies/procedures.
- Partner with HCC leadership and HCCOs to create and deliver targeted HCC communications to the HCC community or business partners.
- Assist in developing and/or revising training to support HCC program elements. Collaborate with third-party vendor to communicate training needs.
- Collaborate with HCC Officers to facilitate revisions to HCC policy manual and supporting policy documents as needed
- A minimum of a Bachelors' Degree or equivalent degree
- Minimum of 1 year business experience
- Excellent English verbal and written communication skills, including formal presentation skills.
- Ability to collaborate in a cross-functional team environment.
- High quality standard with a strong work ethic and professionalism to co-workers and customers.
- Experience identifying and/or implementing process improvement.
- Skill analyzing large data sets.
- At least 1 year in HCC or a compliance related area: monitoring, testing, auditing, finance, compliance, regulatory, law, or a related field
- Ability to work in a complex business environment required
- Demonstrated experience in prioritizing needs and implementing system or process enhancements preferred.
- The ability to break apart large/complex issues into manageable components using analytical skills is necessary.
- Experience working with database and reporting tools preferred.
- Prior experience and/ or training in analytics is preferred.
- Knowledge and experience in the application of web-based reporting tools, website maintenance and/or knowledge of SharePoint is a preferred. Experience in Healthcare Compliance transparency reporting or financial data analysis is preferred
- Experience with data modeling tools
- Self-starter with ability to work independently is preferred
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healthcare compliance specialist - New Brunswick, NJ, USA, United States - Ampcus Incorporated
Description
The Lead Analyst will provide support coordinating the operational Health Care Compliance (HCC) program elements for the Innovative Medicine North America (NA), and Global Functions (GF) organizations, including but not limited to the development and consistent administration of policies & procedures, training, communications, risk assessment, metrics reporting, transactional and material reviews, select review and approvals, and testing & monitoring programs.
The HCC Program Management Analyst will engage and support the HCC Officers (HCCOs) to provide sustained support and build partnerships with all levels of management, employees, and contractors.
Key Responsibilities:
Education:
Experience and Skills:
Required:
Preferred: