About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Compliance Audit Analyst
McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Compliance Audit Analyst, to join in leading the organization forward.
MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).
MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
Position Summary:
Responsible for identification, analysis, and performance of compliance audits in all lines of business, consistent with State, Federal, and Health Plan policies, regulations, and contractual requirements, not limited to, detect, prevent, and respond to potential instances of non-compliance. Responsible for supporting all aspects of the Compliance Program. Performs quality assurance activities on analytics for all product lines to identify non-compliance with regulations and procedures. Analyzes, reviews, and presents information on audit outcomes to support business decisions.
This position is fully remote.
Qualifications:
Required:
- Associate Degree in business, health care or related field.
- Two (2) years of progressively more responsible position using auditing and/or analytical skills.
Preferred:
- Bachelor’s Degree in business, health care or related field.
- Two (2) years of compliance or related experience in health care or related field.
- Two (2) years’ experience and knowledge of HMO, or PPO Course work or work experience in statistics.
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
