Quality and Reporting Analyst / Audit

Auditing Operations Compliance

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

This position is responsible for auditing operations compliance with accreditation and regulatory requirements in assigned areas. Ensuring compliance with Plan, BCBSA, NCQA and State and Federal requirements. Researching and reporting monthly on trends. This will include monthly documented summaries, receipts, and how these impact accreditation requirements. Recommending and implementing technical solutions (i.e. Enterprise Appeals Application requirements) and communicating to the management team of the need / gap. Gathering data, analyzing data, and preparing reports including disseminating information from various sources and systems. Supporting projects and initiatives and resolving issues by working with staff within the department or across departments.

Required Job Qualifications :

• Bachelor's degree and 2 years of insurance experience OR 6 years' insurance experience.
• Knowledge of health care regulatory and legislative process; experience reading and interpreting legislation.
• Knowledge or experience reviewing accreditation standards and evaluating level of compliance, identifying challenges and proposing solutions.
• Knowledge or experience monitoring compliance and managing evidence documents.
• Experience preparing monthly reports and forecasting.
• Research and analytical skills.
• Detail orientation and organizational skills; experience meeting deadlines on time.
• Clear and concise verbal and written communication skills.
• PC proficiency to include Word, Access, Excel and Cognos.

Preferred Job Qualifications :

Pay Transparency Statement :

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting careers.hcsc.com / totalrewards . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement :

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $40,900.00 - $91,000.00 Exact compensation may vary based on skills, experience, and location.

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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process.