JOB TITLE: MANAGER - COMPLIANCE MONITORING & AUDITING (36350037)

Location: Bellaire, TX 77401 / Remote
Job Type: 3 Months Contract
Shift: Remote

Duties: Manage, oversee, monitor, and conduct internal and external auditing and real-time monitoring activities related to the Health Plan’s regulatory and contractual requirements in accordance with the Compliance Program, as well as associated compliance oversight and reporting to align with regulatory and contractual requirements in accordance with the Compliance Program, and with HHSC, TDI, NCQA and Health Plan Senior Management.

• Ensure ongoing compliance with federal and state regulations and provide guidance and tools to assist the Health Plan in developing an auditing and monitoring program. Develop comprehensive audit tools to objectively measure internal performance and performance of third parties (i.e. subcontractors) against Health Plan metrics, policies, regulations, and industry standards. Internal and external audit tools with measurable metrics will be created with feedback from Senior Management and must be reviewed and/or revised at least once annually.

• Ensure ongoing compliance with federal and state regulations and provide guidance and tools to assist the Health Plan in developing an auditing and monitoring program. Develop comprehensive audit tools to objectively measure internal performance and performance of third parties (i.e. subcontractors) against Health Plan metrics, policies, regulations, and industry standards. Internal and external audit tools with measurable metrics will be created with feedback from Senior Management and must be reviewed and/or revised at least once annually