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Years of Experience
Date Last Verified
Compliance Analyst Responsibilities: As a member of the Compliance team, responsible to deliver an effective compliance program. This entails designing, implementing, delivering, measuring and refining activities and controls to preventing, detecting and correcting violations of state, federal and other laws. May include, risk assessment, training, monitoring, auditing, external audit coordination, investigation, root cause analysis, regulatory implementation, control assessment, reporting, corrective actions. May be specific to a product line or area, or may have a broader scope. Special projects may be assigned as needed.
Qualification and Experience
Qualifications: Proven ability to deliver effective Core Compliance activities including, monitoring, auditing, root cause analyses and corrective actions. Skilled in project management and delivery including proven ability to initiate and manage multiple projects and priorities. Excellent written and oral communication and presentation skills. Excellent research and analytics skills, with proven ability to distill actionable, practical advice from diverse sources and opinions. Legal research skills preferred. Proven ability to influence effectively at all levels of the organization. Excellent independent judgment and decision-making skills. PC literate with office computer software – Word, Excel, PowerPoint, Outlook, Visio, etc.
Compliance Analyst I: Bachelor’s degree or equivalent experience and 3 years of experience in a role demonstrating success in compliance-related activities and controls (e.g., risk assessments, training, monitoring, auditing, investigations, root causes analyses, control assessments reporting or corrective actions) with experience in a health care or Medicare-regulated environment preferred.
Compliance Analyst II: Bachelor’s degree or equivalent experience; 5 years of compliance experience or equivalent related experience, with experience in a health care or Medicare-regulated environment preferred; and would also have: Demonstrated fluency in organizational agility, Practical familiarity with legal requirements relating to assigned compliance program, Demonstrated mastery of at least four Compliance functions, to include the core competencies: risk assessments, training, policies and procedures, monitoring, auditing, external audit coordination, control assessments, reporting, corrective actions, implementation oversight, and ability to perform those compliance functions effectively within that compliance program; or if assigned to a specialized function (e.g. FDR/ DDE Compliance, Marketing Materials Review, Data Validations), mastery of all competencies related to that specialized function. Ability to handle successfully at least medium-complexity, medium-difficulty issues and cases end-to-end. Ability to drive successful outcomes with challenging partners at all levels of the organization
Compliance Analyst III: Bachelor’s degree or equivalent experience and a Master’s or JD Degree preferred; 7 years of compliance experience or equivalent related experience, with experience in a health care or Medicare-regulated environment or ACA-regulated environment preferred; and in addition to Compliance Specialist II requirements would also have: Demonstrated excellence in organizational agility: Builds effective relationships at all levels of the organization; influences decision-making; effectively frames issues and dialogues; drives successful outcomes. Demonstrated mastery of legal requirements relating to assigned compliance program. Demonstrated mastery of at least 6 core compliance functions, including the core competencies and ability to deftly perform all compliance functions relating to assigned compliance program as needed. Demonstrated, end-to-end operational knowledge relating to assigned compliance program. Demonstrated peer mentoring and leadership within the department. Demonstrated ability to handle successfully the most complex, most difficult issues and cases end-to-end. Demonstrated ability to drive successful outcomes with the most challenging and/or most elevated partners.
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