Compliance and Quality Analyst 1

Compliance and Quality Analyst 1 Detroit, MI Job Details Full-time 1 day ago Benefits Health insurance Dental insurance Paid time off Vision insurance 403(b) Opportunities for advancement Prescription drug insurance Pet insurance Qualifications Vendor contracts Computer science Contract review Document review (document control) Internal controls Utilization review Computer Science Audit report preparation Data analysis skills Compliance audits & assessments Filing Mid-level Contract management in healthcare Financial analysis 3 years Bachelor's degree in business administration Administrative experience CMS regulatory compliance Analysis skills Driver's License Bachelor's degree Task prioritization Centers for Medicare and Medicaid Services (CMS) Data entry Financial regulatory compliance investigation Organizational skills Human Services Investigative reports Business Administration Accounting standards Continuous quality improvement (CQI) Productivity software Contract negotiation Bachelor's degree in accounting Business Bachelor's degree in human services Bachelor's degree in computer science Accounting Communication skills Technical Proficiency Time management Full Job Description Who Are We and What We Do? The Detroit Area Agency on Aging (DAAA) Region 1-A is a private, non-profit organization responsible for planning, coordinating, developing, and funding services for older adults in the cities of Detroit, the five Grosse Pointes, Hamtramck, Harper Woods, and Highland Park. We're seeking a talented and motivated Compliance and Quality Analyst 1 to join our innovative team. In this role, you will work simultaneously in the programmatic, fiscal, and planning functions of the DAAA. This position is housed in Compliance/Quality and will interact with the entire organization. Multi-tasking and working with others are mandatory for this position. This position is responsible for conducting field assessments/audits; data entry and financial analyses; monitoring the performance of program service providers, including verifying that service providers are in compliance with appropriate rules, regulations and governing laws and standards; utilizing standard accounting rules and principles; managing internal control policies and procedures; preparing and submitting analytic reports, auditing documents for quality, compliance and working in various databases on various software; and data management, financial analysis, and reporting. This position will assist with credentialing, and various other compliance reports due into the OIG, MDHHS, CMS and other governing bodies. This position will monitor the compliance hotline and assist with FWA investigations and any type of compliance investigation. Performs various administrative duties including managing of files. If you're passionate about serving the aging population and thrive in a collaborative environment, we want to hear from you. We invite you to apply and be part of a team that truly values your contribution. We offer competitive wages and are committed to fostering a workplace where growth, teamwork, and serving the aging population are at the forefront. The Benefits of Joining Our Team

• We Offer:

  Comprehensive Health Coverage
• including medical, dental and vision Generous Paid Time Off Pet insurance Prescription drug insurance 403(b) Flexible work week schedule Supportive Culture
• A collaborative and inclusive environment where your ideas are valued Career Development and Opportunities for Advancement Employee Recognition Other attractive benefits

Essential Duties Performed:

Conduct financial and program assessments in compliance with Federal and State regulations and accounting standards Review proposals, negotiate and review service provider contracts Complete claims audits, utilization reviews and various other audit processes Monitor performance of service providers Provide technical assistance to the service provider network, as needed Prepare reports and analyses, as required by management including but not limited to OIG, and various other state and federal reports. Complete and assist with the implementation of Clinical Quality Initiatives, Quality improvement projects and documentation reviews for errors. Audit participant, provider, and provider employee files based on provider monitoring guidelines Perform other duties as assigned

Education:

Bachelor's degree from an accredited college or university in quality, business administration, accounting, computer science, or human services with audit experience, preferred.

Experience:

Three (3) years of related experience. Familiarity with internal control auditing procedures. 1-2 years' experience in billing claims audit desired 1-2 years' experience in quality desired Investigative reporting experience Requires strong critical thinking and analytical competencies, and superior planning, communication, and organizational skills. Must possess a valid drivers' license and can travel by vehicle in the Southeastern Michigan community. Proficiency in MS Office (MS Excel and MS Word, in particular) Excellent time management skills and the ability to prioritize work Attention to detail and problem-solving skills Excellent written and verbal communication skills Strong organizational skills with the ability to multi-task Knowledge of technical and professional principles and skills of accounting for not-for-profits, as required Ability to work with minimum supervision Ability to work effectively within the policies and procedures of the Agency Ability to be flexible in a day to day setting that often has priorities changing on a regular basis Core Competencies This individual must be able to demonstrate strong analytical and problem-solving skills, exercise sound judgment, activities. The person should be forward-thinking and creative, with high ethical standards, and an appropriate professional image. Operate as a strategic visionary with effective communication, sound technical skills, analytical ability, good judgment and strong operational focus. Be a well-organized and self-directed individual who is a team player.

Servant leadership:

The individual should have exceptional listening skills, high level of energy and integrity; compassion for elderly and the community as well as the staff; is centered and mature; exercises durability, adaptability, and a sense of humor. Values fun in the workplace as an integral instrument of staff motivation and operates with a spirit of excellence.