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Compliance Auditor in Harrisburg, PA at KEPRO

Date Posted: 11/29/2018

Job Snapshot

Job Description

Since 1985, KEPRO has helped more than 20 million members lead healthier lives through clinical expertise, integrity and compassion. KEPRO was founded by physicians and clinical expertise is at the core of our organization. We are a leading quality improvement and care management organization. We offer innovative and outcomes-focused solutions to reduce the unnecessary use of health care resources and optimize the quality of care for public and commercial clients. KEPRO’s tailored programs maximize members’ quality of life, and realize greater cost savings for members and clients alike. KEPRO is on a journey to transform medical management and to develop customized solutions tailored to our client’s specific business requirements, while improving the quality of life for patients, reducing costs, and achieving return on investments for our clients. Our approach to medical management is holistic and compassionate and is coordinated around a patient’s entire healthcare experience.

Compliance Auditor

Summary Description 

Provides audit review and examination to Company contracts as auditor for the Compliance & Ethics Department. Working closely with members of the Department and the Operations team, the Compliance Auditor will lead, coordinate and maintain all aspects of the contract audit review and examination process, including but not limited to supporting the tracking and monitoring activities in Compliance 360®, business registrations, licensures, administrative and departmental matters and other ancillary matters, as directed.

Primary Duties and Responsibilities 

  • Lead the Compliance & Ethics audit review and examination of contracts to ensure compliance with internal control procedures and contractual requirements by examining records, reports, operating practices and documentation in fulfillment of one of the principal components of an effective compliance and ethics program — ‘monitoring and auditing’ (USSC Sentencing Guidelines Manual, Section §8B2.1).
  • Execute auditing review and examination of all contracts through Compliance 360®, as directed, to confirm contract deliverables are properly identified and monitored by the Operations team. (COMP.031)
  • Ensure precise and accurate completion of the deliverable assessment questionnaire through Compliance 360®. (COMP.031)
  • Perform assigned compliance and substantive testing procedures for Company audits. Identify and evaluate internal controls to strengthen compliance culture throughout the Company.
  • Prepare and/or contribute to the preparation of Audit and Examination Reports and other written communication, including reviewing and editing team member’s reports.
  • Communicate with supervisor and/or his designee by preparing reports and providing information in meetings to make them aware of significant issues that surface in the course of conducting audits.
  • Track, monitor and audit the Company business registrations, UM and other licensures and other indicators, as directed.
  • Provides management reports by collecting, analyzing, and summarizing management information.
  • Enhance the Department and the organizations’ reputation by accepting ownership for accomplishing new and different requests, through your own initiative or as directed.
  • Perform administrative or departmental, as directed.The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time. 

Education 

  • Bachelor's degree from an accredited college or university (preferred field of study: business finance, law, health care administration or other related field) or not less than at least five (5) the equivalent experience in auditing or compliance.

Skills, Knowledge Abilities (SKA)               

  • Strong written and oral communication skills
  • Senior level diplomatic approach to issue identification and resolution
  • Strong computer skills utilizing Microsoft Office, and Visio
  • Ability to handle multiple projects simultaneously and prioritize projects
  • Strong attention to detail and organizational abilities
  • Excellent judgment and the ability to maintain confidentiality
  • Customer service and communication skills
  • Excellent time management/project management skills required              

Experience 

  • Minimum 5 years’ experience in compliance and or contract auditing. Experience in healthcare (Medicaid or Medicare) or insurance industry preferred.
  • Experience with all forms of government solicitations government contracts, including reviewing and understanding pricing, representations and certifications, and subcontracting issues.
  • Experience coordinating and working with varying departments regarding contracts to achieve proposal and program success.

Mental and Physical Requirements        

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.

KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.kepro.com for more information on the KEPRO Family of Companies.

EOE AA M/F/Vet/Disability

KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.

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