Compliance Analyst II - Healthcare Experience Required (Eastern Time Zone)

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Job Summary:

The Compliance Analyst II position is a professional compliance role responsible for supporting the Compliance Program by collaborating and overseeing high risk areas to ensure that the compliance program is effective and efficient in identifying, preventing, detecting, and correcting noncompliance.  

Essential Functions:

Compliance Prevention:

  • Provide analysis, interpretation, training, and education related to requirements as needed to ensure understanding and effective implementation of compliance requirements
  • Support departments with requirement implementation, reporting development, policy and procedure development/review, and readiness testing
  • Collaborate with internal business owners to ensure implementation of the health plan’s business and contractual requirements
  • Work with Compliance leadership to interpret regulations and provide related guidance
  • Assists in review and dissemination to team of Regulatory Distribution Management items (new and changing regulations); works to understand and provide expertise to team on these items and the impact to our work with high-risk business areas

Compliance Detection:

  • Provide Compliance Program support with audit and monitoring, corrective action plan management, data analytics and other projects to ensure proper execution of the Compliance Program workplan and priorities  
  • Analyze relevant business and/or delegate/FDR performance data to ensure compliance with requirements and prepare reports for leadership and business owners
  • Proactively use analytic and research skills to identify potential areas of risk to CareSource and make recommendations or escalate to Compliance Management for issue management, external audit enforcement trending, and related industry corrective actions
  • Support and/or coordinate audit activities with impacted business owners to ensure adequate representation from subject matter experts (SME) for external reviews and audits
  • Proactively maintain documentation, data universes, responses and other written or electronic materials using the proper compliance tools and in accordance with Corporate Compliance protocols

Compliance Correction:

  • Investigate risks and issues with effective research, root cause analysis, and gap analysis for effective remediation and corrective action management
  • Ensure timely, complete, accurate, and concise documentation of identified risks.

Account Relationship

  • Build and maintain positive and strategic relationships with internal and external stakeholders
  • Attend all required implementation meetings and communicate outcomes,  implementation meetings, manage deliverables, and provide guidance to business areas
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s degree in business or related field, or equivalent years of relevant work experience is required
  • Minimum of three (3) years of compliance and/or regulatory experience including one (1) year in Government Program products is required

Competencies, Knowledge and Skills:

  • Strong familiarity with government-funded healthcare programs, including Medicaid, , and the compliance standards imposed upon First Tier, Downstream and Related (FDR) entities
  • Familiarity with Healthcare operations and/or clinical concepts, practices and procedures is preferred
  • Data analysis ability to produce meaningful insight and drive appropriate action
  • Demonstrated understanding of Compliance and Regulatory fundamentals specifically related to managed care and government programs (CMS/HHS/DOI/Medicaid)
  • Ability to conduct research and analysis of Federal, State, and relevant industry regulatory and enforcement
  • Proven ability to effectively manage work through prioritization, preparing, effective scheduling, leveraging resources and maintaining focus
  • Demonstrated professional communication skills, to include proper grammar usage, document structure, and business writing to audiences including but not limited to internal Leadership at all levels, internal and external Legal Counsel, Corporate Compliance, State and Federal Regulators
  • Advanced organizational, project management and scheduling skills
  • Strong decision making and problem-solving skills
  • Ability to work independently and within a team environment
  • Demonstrated success in working in a matrixed environment
  • Detail orientated with focus on maintaining accurate information in tools as required
  • Demonstrated critical thinking skills
  • Negotiation skills/experience
  • Time management skills including creation and maintenance of project timelines
  • Advanced level experience in Microsoft Word, Excel and PowerPoint

Licensure and Certification:

  • Certified in Healthcare Compliance (CHC) or Certified Compliance and Ethics Professional (CCEP) preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time
  • Must be able to accommodate for Eastern Standard Time Zone work hours

Compensation Range:

$72,200.00 - $115,500.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business


 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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Top 25 Common Interview Questions and Answers

To get a job means you must be ready for an interview. Most people get confused about how they should face an interview to impress the employer. The fact cannot be ignored that landing an interview is no less than a huge achievement as we know how competitive today’s world is. Clearing an interview means you would be securing the job. It does not matter if you are a fresh graduate, are supposed to transition your career, or believe to have a higher position, preparing for an interview is important indeed.

Here, we are going to share the top 25 highly common interview questions along with tips as well as sample answers to help you stand out from others in today’s highly competitive job market in the USA.

1. Give me your introduction in short.

This is the most common questions asked by every interviewer. The fact cannot be ignored that it irritates sometimes as well. But the fact cannot be ignored that it is important as well to fetch important information about an employee.
“Myself ....(your name)…. and I hold a degree in ……….(your field name)……… from…..(university name)... .over….(duration of your). I hold experience in ….(respective field)... .specialized in ….(share your genre)... .Currently, I am working on a project and received positive reviews from the employer.

2. Describe your excellent achievement in your job career.

My greatest achievement was leading a team to do a prominent project within a stipulated time and budget. And that project set our company different from its competitors among our clients.

3. What are the reasons to work with us?

Upon asking this question, you should emphasize that you are aware of the company’s profile and adhere to align your values with theirs. I have always admired this company because of its sustainability and innovation factors. I will keep working with you and contribute to taking it to the next level.

4. Reasons to quit your last job.

The reason to quit my last job is to seek more new challenges and opportunities for growth. I want to hone my skills in a new environment. I believe in keeping going on with new challenges as I think that comfort zone eradicates your creativity.

5. What about your strengths?

Here, you need to be smart and relevant both at the same time. Problem Solving is one of my key strengths. I believe in focusing on the solution and can improve your efficiency by 20% by introducing strategic solutions.

6. What is your weakness?

I believe in doing every work with so much perfection and it takes me slow sometimes. However, I am trying to balance quality and efficiency by dividing my attention towards goals and deadlines.

7. Why should we hire you?

With my huge experience in …………. And holding a proven track record of delivering projects within time, I believe in my ability to cater to your team effectively. Moreover, I believe in giving the best to my work as it brings personal satisfaction to me.

8. In your previous company, what prominent challenges did you face, and how did you deal with them?

In my previous company job profile, we faced a sudden budget cut and delivered a project within the stipulated time with no huge team. I led my team and accomplished that project within that limited budget and time without compromising project quality. Accomplishing a project within a limited budget always makes me feel proud.

9. What is your ideal way to tackle stress and pressure?

I believe in being organized and prioritizing tasks. Once you know how much time you need to give to a particular task, it helps to cut down on high pressure. I believe in making a strategy to get the most out of it. I believe in being calm under pressure.

10. What is your way to prioritize your work?

I believe in going with the deadlines and significance of the project to keep myself productive and free from stress. Moreover, I keep working on a progress tracker to keep boosting my energy.

11. Things that motivate you.

Solving complex issues is what keeps me motivated and seeing the tangible results of my work. Moreover, dynamic as well as innovative environments always boost me up.

12. What is your way of handling criticism?

I always see criticism as a way to hone my skills and an opportunity to learn and grow. I always listen quite carefully and act accordingly to come up with satisfactory results.

13. Describe a time you worked in a team.

I collaborated with a diverse team in my last company to come up with a new marketing strategy. My role in that team was to integrate social media efforts resulting in 25% increased engagement.

14. What is your way of dealing with difficult coworkers?

I am a firm believer in addressing conflicts directly and professionally to come up with a solution. Open communication is my asset and understanding different perspectives to solve issues amicably.

15. Reasons to get this job?

This job sits well with my skills in this field as well as my passion for learning more about new things. I am excited to contribute and learn more in your company professionally.

16. How would you be handling multiple deadlines if given?

The simple thing from my perspective is to stay organized and divide the tasks into manageable steps. I believe in doing the work based on urgency and impact.

17. Tell us about the time you failed badly in your job.

Once I missed a significant deadline because of not being good at time management. This is how I learned about time management and being adhered to realistic goals to improve my planning skills in an ideal manner.

18. How do you see yourself outside of work?

I enjoy reading a lot related to my profession. Moreover, reading makes me calm too. Apart from that, hiking and roaming to peaceful places are my favorite things to do.

19. What are your salary expectations?

Following my research and the responsibilities of the role, I expect a salary in the range of $...... to $..... Though, I am open to knowing your side as well.

20. What do you expect from yourself in the next five years?

I am a keen learner and want to expand my knowledge by getting associated with your company. I want to take on more leadership responsibilities and contribute to achieving success in highly creative ways.

21. What do you think about the latest industry trends and changes?

I believe in keeping myself updated about the latest and ongoing industry trends and changes. I keep following the latest job profile e-newsletter; and also attend relevant webinars and conferences. Learning is a never-ending process.

22. How do you describe your ideal work environment?

For me an ideal work environment is all about having open communication and teamwork to achieve success, to learn more, and to have excellent professional growth.

23. How aware are you of our company?

I know this company has established itself as one of the prominent companies in today’s tech industry. It is known for its excellent solutions, creative ways, and commitment to sustainability. The current services and their success rate make this company completely different from others.

24. What skills can you add to this job?

I have been in this field for the past 5-6 years and hold huge experience identifying trends that lead to exceptional business growth. I am also good at communication and teamwork to make the most of it.

25. Do you have any questions for us?

Yes, I would like to know more about the team I would be working with. What sort of challenges are the team currently going through? What is about the career growth in this company?