Business Analyst – Program Integrity Vendor Audits (Remote)
We are looking for a meticulous and analytical Business Analyst to oversee the management of third-party vendors. This role will be responsible for analyzing vendor performance, identifying cost-saving opportunities, and is critical in ensuring vendor compliance with contractual, regulatory, and operational standards. The ideal candidate will bring strong analytical skills, audit/claims experience, and a collaborative mindset to support risk mitigation and performance improvement across the vendor landscape.
Key Responsibilities:
• Analyze audit findings and vendor performance data to identify trends, risks, and improvement opportunities.
• Data extraction & Analysis
• Regulatory Reporting & KPI Development
• Serve as a liaison between vendors and providers to resolve issues and improve service delivery.
• Track and evaluate vendor performance using KPIs and SLAs.
• Conduct regular vendor reviews and audits to ensure compliance and quality standards.
• Evaluate vendor adherence to Business Associate Agreements (BAAs), SLAs, and quality standards.
• Recommend enhancements to vendor audit frameworks, tools, and documentation practices.
• Contribute to the development of policies and procedures for vendor oversight and governance.
• Support continuous improvement initiatives in vendor lifecycle management.
• Maintain documentation of audit procedures, findings, and follow-up actions.
• Contribute to the development of vendor audit policies and workflows.
Preferred Skills:
• Knowledge of Databricks
• Knowledge of SQL
• Experience in regulated industries (e.g., healthcare, finance, insurance).
• Experience and/or knowledge of medical coding and inpatient auditing
Education
• Bachelor's Degree (Required)
Certification/Licensure
• No specific certification or licensure requirements
Experience
• 3+ years of relevant experience in business analysis, data reporting, or analytics (Required)
• Must have 3+ years of experience in business analysis, auditing, claims, vendor management, or compliance.
• Knowledge of business intelligence (BI) tools, SQL querying, and reporting software.
• Required to have experience working with health insurance, claims data, and auditing claims data
• Excellent written and verbal communication skills.
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$53,476.80-$89,128.00. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
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Key Responsibilities:
• Analyze audit findings and vendor performance data to identify trends, risks, and improvement opportunities.
• Data extraction & Analysis
• Regulatory Reporting & KPI Development
• Serve as a liaison between vendors and providers to resolve issues and improve service delivery.
• Track and evaluate vendor performance using KPIs and SLAs.
• Conduct regular vendor reviews and audits to ensure compliance and quality standards.
• Evaluate vendor adherence to Business Associate Agreements (BAAs), SLAs, and quality standards.
• Recommend enhancements to vendor audit frameworks, tools, and documentation practices.
• Contribute to the development of policies and procedures for vendor oversight and governance.
• Support continuous improvement initiatives in vendor lifecycle management.
• Maintain documentation of audit procedures, findings, and follow-up actions.
• Contribute to the development of vendor audit policies and workflows.
Preferred Skills:
• Knowledge of Databricks
• Knowledge of SQL
• Experience in regulated industries (e.g., healthcare, finance, insurance).
• Experience and/or knowledge of medical coding and inpatient auditing
Education
• Bachelor's Degree (Required)
Certification/Licensure
• No specific certification or licensure requirements
Experience
• 3+ years of relevant experience in business analysis, data reporting, or analytics (Required)
• Must have 3+ years of experience in business analysis, auditing, claims, vendor management, or compliance.
• Knowledge of business intelligence (BI) tools, SQL querying, and reporting software.
• Required to have experience working with health insurance, claims data, and auditing claims data
• Excellent written and verbal communication skills.
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$53,476.80-$89,128.00. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Apply tot his job
Apply To this Job