What will your job look like?
The Compliance Auditor will be responsible for facilitating Client audits and supporting internal compliance operations. The Compliance Auditor may be responsible for fielding questions throughout Client audits, representing MTM in a professional and positive manner and interpret contract requirements as it relates to MTM’s operational procedures, compliance with state and federal regulations and contract compliance. The Compliance Auditor will oversee policies and procedures, provide needed support during the URAC accreditation process, and manage other projects, as required.
Location: Hybrid/Remote if located within 40 miles of an MTM office.
What you’ll do:
Plan and implement effective audit processes for both internal and external audits
Facilitate remote and on-site external audits
Interpret contract requirements and communicate expectations to needed internal stakeholders
Support in the development and utilization of internal controls to ensure continuous compliance
Help implement risk management strategies for the organization(s)
Utilize the selected tracking method to record audit investigations, documentation, results, and recommendations
Compile quarterly, and upon request, summaries of audit investigations, findings, and resolutions
Continuously promote process improvement and process integrity throughout the organization(s) while partnering with other departments to develop practical solutions
Assist and guide process owners in the assessment of processes for improvement and standardization opportunities, while minimizing rework, reducing cost, and improving quality output
Assist with the creation, review, and update of MTM policies and procedures to ensure thorough and pertinent documentation; oversee MTM (and affiliates) policies, procedures, manuals, and processes to ensure contractual compliance and process efficiency
Act as a liaison between MTM and/or affiliates and external auditors
Report compliance concerns to the Compliance Officer, Director of Compliance and Audit and other executive staff as indicated
Prepare for external audits by completing audit tools, compiling supporting documentation for audit sample, and referencing policies, procedures, and contracts to validate compliance
Conduct monitoring, reporting, and follow-up on all Corrective Action Plans
Apply policies/procedures and client contract obligations to designated audits
Create relevant workflows, audit tools, and tracking mechanisms as assigned
Provide any needed support to ensure ongoing compliance with URAC standards
Assist in developing audit reports and presenting findings and recommendations to leadership, as needed
As needed, conduct quality improvement projects for the Quality Improvement Program
Assist with the development and execution of compliance program activities and projects as assigned
What you’ll need:
Experience, Education & Certifications:
High School Diploma or G.E.D.
Bachelor’s Degree or equivalent experience in compliance
At least 2 years’ experience in an Compliance/Auditor role
Experience monitoring contract and regulatory compliance, required. Experience working with MCO contracts or other state clients strongly preferred
Skills:
Must possess the ability to assess potential problems and make sound judgments around issues that may have an adverse effect on the business
Detail-oriented, thorough, and a systematic/methodical approach to projects
Strong project management
Ability to present complex information in a simple and compelling manner
Ability to multi-task, set priorities and meet deadlines
Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint, SharePoint)
Strong people management skills
High level of emotional intelligence
Excellent interpersonal skills
Ability to work well under pressure
Ability to work independently and also collaboratively with others to achieve defined goals
Excellent written and oral communication skills
Outstanding analytical and organizational skills
Ability to maintain high level of confidentiality
Regular attendance is required
Ability to identify areas of improvement and provide recommendations
Even better if you have...
Previous experience in Medicaid or state public assistance programs preferred
Experience working for a managed care organization or healthcare provider preferred
What’s in it for you:
Health and Life Insurance Plans
Dental and Vision Plans
401(k) with a company match
Paid Time Off and Holiday Pay
Maternity/Paternity Leave
Casual Dress Environment
Tuition Reimbursement
MTM Perks Discount Program
Leadership Mentoring Opportunities
Salary Min: $47,920
Salary Max: $71,880
This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss this with us as you move through the selection process.
Equal Opportunity Employer: MTM is an equal opportunity employer. MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law. If you are in need of accommodations, please contact MTM’s People & Culture.
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