Program Integrity Audit Analyst II

CoventBridge Group
Grove City, OH
Category Accounting
Job Description
CoventBridge Group is seeking a Program Integrity Audit Analyst II to perform evaluation and development of leads associated with performance audits of Medicaid Managed Care Plans. This role involves identifying potential fraud, waste, and abuse, issuing findings and recommendations, and ensuring proper contract compliance. The analyst will work collaboratively within the Grove City, OH office and remotely from a home office. They report directly to a Program Integrity Audit Supervisor.

Requirements

  • Understanding of state Medicaid programs and managed care plan delivery systems.
  • Planning, coordinating, and conducting performance audits in accordance with Government Auditing Standards.
  • Understanding managed care encounter data and determining areas requiring improved program integrity oversight.
  • Designing and implementing audit strategies for provider payment reviews and managed care plan performance audits.
  • Working with auditors to develop audit plans and documentation.
  • Prioritization and assignment of workload.
  • Preparing and submitting documentation related to payments and compliance.
  • Training new employees.

Benefits

  • Medical, Dental, Vision plans
  • Life, LTD and STD paid by the employer
  • 401(k) with company match up to 4%
  • Paid Time Off and company paid holidays
  • Tuition assistance
  • The salary range for this role is $55,000 to $65,000 annually.
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