Analyst, Compliance Auditing, Monitoring and Analytics

Job description

**Extraordinary Careers.

Endless Possibilities.**

**With the nation’s largest home infusion provider, there is no limit to the growth of your career.**

Option Care Health, Inc.

is the largest independent home and alternate site infusion services provider in the United States.

With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states.

Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.

Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members.

At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow.

Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful.

Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

**Job Description Summary:**

The Analyst, Compliance Auditing, Monitoring and Analytics is responsible for supporting the Compliance program’s risk-based auditing, monitoring and analytics activities to monitor, assess, and optimize compliance with all laws, regulations and guidelines with Federal and State programs.

This role requires a strong level of auditing and analytical skills, and the ability to summarize and communicate complex findings effectively.

Reporting to the Senior Manager, Compliance Auditing, Monitoring and Analytics, this individual assists in executing monitoring and auditing projects, to include standard, repeatable processes identifying, documenting and presenting any errors, irregularities or findings, and completion of necessary corrective actions.

Partners with other functional areas and field teams to coordinate audit and monitoring activities from initiation through completion of corrective action.

Designs and implements robust analytics and continuous monitoring strategies to prevent, detect and mitigate compliance risks.
**Job Description:** ​

**Job Responsibilities (listed in order of importance and/or time spent)**

+ Executes the risk-based compliance auditing, monitoring and analytics program to assess the effectiveness of compliance controls and processes across the organization in alignment with the Compliance organizations risk assessments and workplans.
+ Coordinates with internal stakeholders to identify audit objectives, scope, and methodologies, and ensure alignment with organizational priorities.
+ Conduct periodic compliance audits and reviews in accordance with established Compliance workplans, focusing on key risk areas such as regulatory changes, billing and coding, privacy and security, and fraud and abuse.
+ Perform data analysis and review of documentation to identify potential compliance issues, irregularities, or trends, and develop recommendations for corrective actions or process improvements.
+ Monitor compliance with policies, procedures, and regulations through ongoing monitoring activities, including data analysis, trend analysis, and review of key performance indicators.
+ Collaborate with cross-functional teams to implement corrective actions and remediation plans in response to audit findings, and track progress to ensure timely resolution.
+ Identifies policy, procedure, and process gaps and partners with functional leaders to develop responsive corrective measures to prevent reoccurrences.
+ Prepare and present regular reports on audit and monitoring activities, findings, and outcomes to be shared with leadership and regulatory authorities as required.
+ Maintain documentation of audit and monitoring activities, including work papers, findings, recommendations, and corrective actions, in accordance with established recordkeeping requirements.
+ Utilize advanced analytics techniques to analyze large datasets, such as related to healthcare operations, billing, claims, and patient information to support Compliance activities and to identify trends, anomalies, and potential compliance risks.
+ Design and build monitoring dashboards and other data visualizations using common tools such as PowerBI; leverage other Microsoft suite tools as well to collect, organize and analyze data.
+ Collaborate with cross-functional teams to develop and implement analytics-driven, risk-based capabilities to continuously monitor compliance with internal policies and federal, state, and local regulations.
+ Always respect and maintain the confidentiality of sensitive business and patient information.
+ Always maintain files and work papers consistent with Option Care Health policy and compliance processes.
+ Stay abreast of changes in healthcare regulations, industry trends, and best practices in compliance auditing and monitoring and analytics, and proactively identify opportunities to enhance compliance processes and systems.

**Supervisory Responsibilities**

Does this position have supervisory responsibilities?

(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

No **X**

Yes

**Basic Education and/or Experience Requirements**

+ Bachelor's degree in business, auditing, accounting, data science, finance, statistics, healthcare administration, or related field.

Comparable professional experience will be considered.
+ Minimum of 2-3 years of experience in compliance, audit, analytics or related field involving conducting data analysis and building digital tools such as dashboards and other types of reporting.

**Basic Qualifications**

+ Demonstrated experience in supporting risk management of an organization, including but not limited to, Compliance, Internal Audit, Finance/Accounting, Enterprise Risk Management, IT Governance & Controls.
+ Demonstrated experience designing and implementing auditing and/or monitoring programs.

Intermediate proficiency in analysis and audit techniques and documentation review, with the ability to be thorough and objective.
+ Strong analytical, problem-solving, and critical-thinking skills, with the ability to translate complex data into actionable insights.
+ Demonstrated proficiency and enthusiasm for data analysis and reporting tools and techniques, such as PowerBI, Tableau, Alteryx, SQL, Python, R, or similar platforms.
+ Intermediate to advanced proficiency in Microsoft Office Suite, including at minimum Excel, Word and PowerPoint.
+ Experience managing multiple projects at the same time including organization, time management and regular status reporting to supervision including progress, roadblocks and support needed.
+ Strong communication and interpersonal skills, with the ability to build relationships, prepare reports and communicate findings and recommendations in a clear and concise manner.
+ Self-motivating and taking responsibility for personal growth and development; supports the development of others; fosters an inclusive and diverse team environment and participates in connectivity and continuing education opportunities.
+ Experience working collaboratively with cross-functional teams to better understand the business and to develop and implement risk mitigation solutions.

**Travel Requirements: (if required)**

Traveling required up to 25% of the time.

**Preferred Qualifications & Interests (PQIs)**

+ Experience with healthcare laws and regulations, preferably with compliance requirements related to billing and coding, privacy and security, and fraud, waste and abuse, including but not limited to HIPAA, Anti-Kickback, Stark, Medicare/Medicaid reimbursement.
+ Experience evaluating information to determine compliance with policies, standards, laws, and regulations.
+ Intermediate level of coding is strongly preferred, as is familiarity with statistical methodologies.
+ Certified in Healthcare Compliance (CHC), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), or similar certification preferred.
+ Direct experience in home infusion services, pharmacy and/or nursing compliance programs.
+ Direct experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines.
+ Proficiency with audit software or other governance, risk and compliance (GRC) tools more broadly.

Due to state pay transparency laws, the full range for the position is below:

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $70,218.51-$117,008.35

**Benefits:**

-Medical, Dental, & Vision Insurance

-Paid Time off

-Bonding Time Off

-401K Retirement Savings Plan with Company Match

-HSA Company Match

-Flexible Spending Accounts

-Tuition Reimbursement

-myFlexPay

-Family Support

-Mental Health Services

-Company Paid Life Insurance

-Award/Recognition Programs

_Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information._

​

For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy.

With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost.

Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites.

We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.

Required Skill Profession

Other General