Compliance Auditor

1 month ago

Nashville, United States Sevita Full time

At Sevita, we believe that everyone deserves to live well. For more than 50 years, our team members have provided home and community-based health care for adults, children, and their families across the United States. Our extraordinary team offers innovative, quality services and support that lead to growth and new opportunities for the people we serve and for our employees.

Summary

The Compliance Auditor is responsible for auditing/monitoring compliance requirements across all Company business units and service lines. Collaborates with Ethics and Compliance Officers to contribute to projects related to the Compliance Audit, Self-Monitoring, Data Mining and Risk Assessment programs. Supports the leadership of the Company and the Chief Compliance Officer.

This position is remote and can be performed from anywhere in the U.S. There is some travel required.

Responsibilities:

  • Acts as an accessible, visible and available subject matter expert to the business as it relates to audits.
  • Establishes a compliance culture as a strategic, competitive advantage with each audit performed.
  • Evaluates areas of risk to be addressed by each audit. Interprets the relative significance of issues needing resolution; escalates at appropriate time.
  • Assists in the development of the annual Compliance Audit Plan and Company Compliance Plan.
  • Conducts scheduled and non-scheduled compliance audits according to the audit plan while testing compliance with appropriate federal, state, and local regulations and standards; internal policies and procedures; and external accreditation standards.
  • Performs risk assessments to identify compliance and non-compliance concerns.
  • Implements on-going compliance audits by creating and enhancing audit tools relating to audit/monitoring activities and/or researching, and investigating issues
  • Designs and performs risk assessments to identify compliance and non-compliance concerns.
  • Performs risk assessments to identify compliance and non-compliance concerns.
  • Implements on-going compliance audits by creating and enhancing audit tools relating to audit/monitoring activities and/or researching, and investigating issues
  • Supports the Compliance Audit team during audits; helps prepare for management discussions regarding identified issues affecting the business and operations.
  • Reviews compliance with existing policies and procedures by performing the required audit steps and reviewing internal controls.
  • Prepares audit reports based on audit findings derived from and supported by audit work papers.
  • Partners with the Compliance Audit team to provide recommendations requiring management responses to address identified observations or findings.
  • Participates in audit exit meetings to review audit report findings.
  • Reviews management responses to determine if recommendations have been satisfactorily addressed. Addresses responses requiring further clarification or support.
  • Develops and maintains current knowledge of laws, regulations, and market changes that impact all aspects of the Company, including, but not limited to, Stark Law, Anti-Kickback Statute, Patient Inducement Statute, Health Insurance Portability and Accountability Act, relevant Office of Inspector General (OIG) Model Guidance and applicable Advisory Opinions.
  • Supports review of new business activities and programs as an audit subject matter expert.
  • Participates in activities related to exclusion screening, as it pertains to new hires, current employees, vendors and providers. Partners to understand and participate in resolution pathways.
  • Utilizes the 5 C's of audits: criteria, condition, cause, consequence, and corrective action
Qualifications:
  • Bachelor's degree required.
  • MBA or advanced Degree/professional certification (CIA/CHC) preferred.
  • 1-3 years' experience in healthcare and/or compliance or an advanced degree without experience.
  • Knowledge of statistical auditing methods and Medicaid reimbursement preferred.
  • Strong ability to communicate orally and in writing to individuals and groups from varied disciplines and levels of management.
  • Knowledge of Strong communication, interpersonal and presentation skills, working with both internal and external individuals and entities
  • Strong ability to self-motivate.
  • Excellent analytical, problem solving, project management, leadership and team building.
  • Strong computer skills with proficiency in Microsoft Office
  • Maintains discretion and safeguards confidential information
  • Travel as needed, approx. >25%.
Why Join Us?
  • Full compensation/benefits package for employees working over 30 hours/week
  • 401(k) with company match
  • Paid time off and holiday pay
  • Enjoy complex work that makes a difference in the lives of those we serve
  • Career development and advancement opportunities across a nationwide network

We have meaningful work for you - come join our team - Apply Today

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We've made this our mission for more than 50 years.

Sevita is committed to providing equal opportunities to all employees and applicants for employment. We are committed to creating an inclusive and diverse workplace that values and respects the unique talents, experiences, and perspectives of our employees and the people we serve.

As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, pregnancy, gender identity or any other characteristic protected by law.

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