Client Audit Manager
American Specialty Health, Inc. is seeking an experienced Manager, Delegation Support, to join our Client Services – Clinical department. The primary purpose of this position is to provide support for client delegation (including pre-delegation) and regulatory compliance audits. The position also supports other delegation oversight compliance efforts, as well compliance-related inquiries/reviews, in consultation with the Sr. Manager, Delegation Support and Director, Clinical Client Services. The position also supports other compliance activities of the department related to internal compliance efforts.
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- Provides support related to complex delegation support activities in consultation with and under the direction of Sr. Manager, Delegation Support.
- Leads audits related to high profile and complex health plans.
- Facilitates and leads internal and external meetings acting as owner of information. This includes creating and distributing meeting agendas, kicking off the discussion with a high-level overview and purpose of the meeting, introductions, and then closing the discussion with action items. This also includes facilitating and leading any internal preparation meetings and/or sending out details to the internal stakeholders prior to the meeting so they have enough information to prepare for their role in the discussion.
- Proactively engages internal customers and subject matter experts to effectively manage internal and external customer expectations.
- Travels, as directed by the Sr. Manager, Delegation Support, to support audits in locations other than the position’s designated ASH office location.
- Provides support for internal compliance activities, as needed, based on direction from Sr. Manager, Delegation Support.
- Actively participates in collaborative team environment to educate, coordinate activities, and resolve unique problems with recommended courses of action to internal stakeholders.
- Accepts and/or returns phone calls from clients within the same business day of receipt, Monday through Friday.
- At a minimum, acknowledges receipt of emails from clients within 24 hours of receipt.
- Maintains timely and accurate documentation of client interactions, activities, processes and issue resolution; ensures meeting minutes and action items are prepared and documented within two days of a client meeting.
- Ensures high level of service to meet client expectations on a daily basis.
- Communicates with Sr. Manager Delegation Support and Director, CTC, on high level issues to ensure appropriate response and resolution.
- Establishes and maintains positive professional relationships with internal and external customers.
- Maintains confidentiality of all reports, files, schedules, databases, and documents; as well as all member, provider, and proprietary information and ensures the Delegation Support team does the same.
- At the direction of the Sr. Manager, Delegation Support, communicates unique aspects of client delegation activities at various meetings with internal and external customers to support delegation functions.
- At the direction of the Sr. Manager, Delegation Support participates in activities related to internal and external process improvements.
- Under the direction of the Sr. Manager, Delegation Support, supports functions of the Compliance Office and with completion of compliance work plan and risk assessment goals and action items.
- Participates in workgroups as designated by the Sr. Manager, Delegation Support.
- Completes assigned action items in a timely and responsive manner or oversees completion of the same by direct reports
- Manages compliance attestation requests from clients requiring Compliance Officer signature, including keeping the Compliance Officer informed of attestation requests and working with department staff and internal stakeholders to monitor and track requirements set forth in attestations, particularly new requests and requests not previously specified via contract with clients.
- Bachelor’s degree in in related field or equivalent experience. If equivalent experience, high school diploma required.
- Advanced training or certification in health care preferred.
- Minimum two years’ experience in health care administration with specific experience in managed care audit support preferred.
- Specific experience in managed care operations, accreditation, regulatory compliance, contract review, coordination of policy and process development, delegation support, and structured meetings.
- Proven experience and developed Customer Service skills required.
- Proficient in MS Office with intermediate experience in Word, Excel and database management.
- Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
- Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- Ability to effectively organize, prioritize, multi-task and manage time.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- Ability to exercise strict confidentiality in all matters.
Primarily sedentary, able to sit for long periods of time.
Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.
Usual office setting.
American Specialty Health is an Equal Opportunity/Affirmative Action Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.
Please view Equal Employment Opportunity Posters provided by OFCCP here.
If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.
ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.