Compliance Senior Auditor

3 weeks ago

Atlanta, United States Sevita Full time

The MENTOR Network is now Sevita. We have a different name, but the same mission, and a renewed sense of purpose. At Sevita we provide home and community-based health care services and support for adults, children, and their families across the United States. Join us in work that matters.



Summary
The Senior Compliance Auditor is responsible for developing, auditing plans, and 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 There is some travel required.

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. Plans, leads and executes 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; manages audits to minimize resources in audited departments. Recommends process, procedure, and or policy improvements to mitigate against identified risks. Designs and performs risk assessments to identify compliance and non-compliance concerns. Supports the Operating Group's Management team during audits to discuss identified issues affecting the business and operations and acts as a resource on audit observations. Reviews compliance with existing policies and procedures by performing required audit steps and reviewing internal controls. Prepares audit reports based on audit findings derived from and supported by audit work papers. Provides recommendations requiring management responses to address identified observations or findings. Conducts audit exit meetings to review audit report findings. Discusses possible management responses with the Operating Group management team to ensure management understands the implications of the observations or findings so that they can respond appropriately. Reviews management responses to determine if recommendations have been satisfactorily addressed. Addresses responses requiring further clarification. Provide assistance to team members with general tasks that require a better understanding of functions, as directed by immediate supervisor. Applies knowledge of compliance and a developed understanding of service lines to all audits and audit projects while working with the Ethics and Compliance Officer and/or business to mitigate the risks that impede the Operating Group's goals. Adapts to and reacts to the needs of a rapidly growing and changing business and understand the complexities of a large organization. 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. Works in conjunction with the law department to better understand operational requirements under the law. Partners with Ethics and Compliance Officer(s) and respective Operating Group management team(s) in the development and review of new business activities and programs as the audit expert. Assists with activities related to outside investigations, including but not limited to potential fraud and abuse issues, which could be either general or targeted. Assists external counsel in identifying and reviewing pertinent documents. Participates in activities related to exclusion screening, which applies to new hires, current employees, vendors and providers. Investigates and resolves any potential matches. Ensures necessary follow-up takes place to resolve open items and that controls are in place to successfully mitigate business and regulatory compliance risks. Completes special projects and reports as needed by the Compliance Department. Performs other related duties and activities as required.

Qualifications:

Bachelor’s degree required. MBA or advanced Degree/professional certification (CIA/CHC) preferred. 2 – 5 years' experience in healthcare and/or compliance or an advanced degree without experience. Previous experience in regulatory/compliance audit preferred. Knowledge of statistical auditing methods and Medicaid reimbursement preferred. Superior ability to communicate orally and in writing to individuals and groups from varied disciplines and levels of management. Strong communication, interpersonal and presentation skills, working with both internal and external individuals and entities. Ability to motivate, lead and coordinate cross-functional teams of senior management personnel. Excellent analytical, problem solving, project management, leadership and team building. Strong computer skills with proficiency in Microsoft Office. Travel as needed, approx. > 25%.

Why Join Us?

Paid Time Off, Holiday Pay, and Health Benefits Career development and advancement opportunities Work with some of the best co-workers you could ask for and see your impact on the lives of those individuals we serve Since our funding comes from Federal and State payers, we offer stability and secure work opportunities

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