Quality Auditor in Columbus, OH at Maximus

Date Posted: 2/19/2021

Job Snapshot

Job Description

MAXIMUS is seeking high-performing, high-potential candidate with HEALTHCARE audit experience familiar with NCQA standards to serve in an audit role for the Ohio Provider Credentialing project.

Essential duties and responsibilities:

•Assist with performing operational and credentialing compliance audits and assessment of provider credentialing services per NCQA requirements.
• Work under supervision of Compliance Manager with moderate latitude for initiative and independent judgment.
• Perform audits in a professional manner with agreed upon scope and time estimate in accordance with audit programs.
• Review documents and system files for compliance with NCQA procedures.
• Create work papers to capture process and procedures and audit test results.
• Use critical thinking and analytical skills to identify, develop, and document audit issues and recommendations.
• Assist in communicating the results of audit and assessments via written reports or oral presentations to management.
• Perform related work as assigned by audit management.

Requirements & Qualifications
• Bachelor’s Degree or equivalent combination of work experience and education.
• 2+ years of related experience.
• Knowledge and experience with NCQA required.
• Experience with Provider Credentialing preferred.
• Excellent oral and written communication skills.
• Team player with ability to work effectively with colleagues at all levels.
• Microsoft Office proficient especially Word, Excel and PowerPoint.


 

Essential Duties and Responsibilities:
- Utilize knowledge of auditing processes to identify risk and spot internal inconsistencies with the goal of continuous improvement.

- Perform audits in a professional manner with agreed upon scope and time estimate in accordance with audit programs.

- Conduct interviews, review documents and audit evidence to perform audit procedures.
- Use critical thinking and analytical skills to identify, develop, and document audit issues and recommendations.

- Assist in communicating the results of audit and assessments via written reports or oral presentations to management.

- Interact directly with co-sourced internal auditors, external auditors, process owners and management.

Minimum Requirements:
- Bachelor's degree with 3+ years of experience.


MAXIMUS Introduction
Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. Maximus delivers innovative business process management and technology solutions that contribute to improved outcomes for citizens and higher levels of productivity, accuracy, accountability and efficiency of government-sponsored programs. With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. For more information, visit https://www.maximus.com.
 
EEO Statement: Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

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