Regulatory Audits & Monitoring Specialist

About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 285,000 members in California, Arizona, Nevada, and Texas. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn; Facebook; and Twitter.

The Job

Supports the Audit Lead with all regulatory audits & readiness activities. This position will also provide support to the Enterprise Monitoring team on the development of new monitoring metrics & activities in direct response to audit findings and/or changes in regulations.

You Will

Assist the Regulatory Lead with all regulatory audits (state & federal).

In this role, the Regulatory Audits & Monitoring Specialist will assist in the coordination of all components of a regulatory audit:

Coordinates:

• Year-round audit readiness activities
• Pre-audit deliverables
• Onsite scheduling and auditor requests
• Post-audit reviews and deliverables
• Post validation reviews
• Audit project plans and calendars

Contribute to the development of policies and procedures for the plan's audit process, repository, and readiness activities. Assist with the standardization of new protocols related to audits.

Draft audit update documents for Enterprise Compliance Committee, Compliance Committee and other committees as requested.

The Regulatory Audits & Monitoring Specialist will also work closely with the Enterprise Monitoring supervisor on the development of new monitoring metrics and activities, in response to audit findings and/or changes in regulatory guidance. This includes:

• Meet with applicable business units to discuss the development of monitoring activities
• Analyzing existing metrics for possible updates due to audit results and/or change in regulations
• Work with the Medicare Compliance team when new regulations are released to ensure appropriate monitoring is in place

This also includes supporting the Enterprise Monitoring Team during the annual CMS Foreign Language/TTY study. And assisting the Enterprise Monitoring Supervisor with monthly metric reporting and e-binder reported to the Enterprise Compliance Committee.

Actively support the achievement of SCAN's Vision and Goals.

Other duties, as assigned.

Your Qualifications

• Bachelor's Degree or comparable combination of education/experience and/or training.
• 5+ years' experience in managed health care required.
• 3+ years compliance experience
• Demonstrated knowledge of the Medicare Advantage Program and its governing regulations.
• Strong interpersonal skills, including proficient written and oral communication skills.
• Detail-oriented, quality work product.
• Ability to prioritize and manage multiple tasks while delivering quality work product.
• Exercises independent thought and decision-making skills.
• Ability to work effectively in a team-oriented environment.
• Proven ability to interact effectively with staff from all levels of the plan

What's in it for you?

• Base Pay Range: $58,200 - $93,100 (Annually)
• Work Mode: Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, plus 1 additional floating holiday
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

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