Compliance Auditor

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 Auditor/Compliance role

• Experience working with MCO contracts or other state clients, monitoring contract and regulatory compliance

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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