About this role
The Auditor (Benefit Administration Program) is responsible for performing internal audits and monitoring activities related to the Over the Counter (OTC) supplemental benefit under Medicare Advantage and Medicaid Plans
The Auditor is also responsible for reporting audit results to management/operational designers and assisting with the development of remediation plans as necessary
ESSENTIAL DUTIES AND RESPONSIBILITIES
Perform internal audits and monitoring activities to ensure compliance with company policies, client contracts, and regulatory guidelinesReport results of auditing and monitoring activities and assist with the development of remediation plans as necessaryTrack the progress of remediation plansProvide assistance with external client audits requestsProvide assistance with OTC catalog and product formulary reviews and maintenanceResearch and respond to complaints and grievancesParticipate in ongoing education and training Bachelor’s degree (B.A.) from a four-year college or university preferred; or one to two years related experience and/or training or equivalent combination of education and experienceKnowledge of Medicare regulations and processes preferredAbility to lead and to work independently, a self-starter, creative thinker with high professional standards and integrity. Ability to thrive in a very busy and complex work environment with changing priorities. All your information will be kept confidential according to EEO guidelines.