Oak Street Health, part of CVS Health
Health Plan Compliance Auditor
Oak Street Health, part of CVS Health, Chicago, Illinois, United States, 60290
Join to apply for the
Health Plan Compliance Auditor
role at
Oak Street Health, part of CVS Health 3 days ago Be among the first 25 applicants Join to apply for the
Health Plan Compliance Auditor
role at
Oak Street Health, part of CVS Health Get AI-powered advice on this job and more exclusive features. At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Role description: The Associate, Delegation Compliance supports compliance activities for Oak Street Health’s internal care management and utilization management teams. They partner with operational leadership to implement and monitor ongoing quality improvement activities, lead external compliance and accreditation survey processes, and leverage program knowledge and analytical skills to effectively coordinate all compliance activities.
Responsibilities
Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal, state, and business requirements for assigned programs, and ensures compliance with program requirements Collaborates with leadership to develop, implement, and maintain policies and procedures for assigned programs Collaborates with leadership to develop and execute auditing and monitoring tools utilized for staff and program audits Collaborates with payers, serves as SME for compliance-related activities Contributes to reports used by internal and external leadership Provides input and valuable feedback on auditing results, trends and improvement activities Recommends process improvement, interventions, and assists with implementation Develops and revises training materials based on QA results Analyzes processes and key performance indicators to assess compliance risk, internal control, and overall effectiveness and efficiency Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practices Develops Corrective Action Plans (CAPs) and Performance Improvement Plans (PIPs) and is accountable for the adequacy of operational responses and ongoing monitoring Performs other job duties, as assigned.
What We’re Looking For
Bachelor’s degree in Healthcare Administration, Compliance, related field, or equivalent experience 1-2 years of compliance experience dealing with care management requirements, utilization management requirements, auditing, reporting processes, action plans, and compliance training preferred Strong understanding of healthcare laws, NCQA requirements, and Medicare Part C regulatory compliance in a managed care organization or hospital health care system setting Experience working with regulators on compliance audits Ability to work independently and with others Experience in building and supporting strong teamwork and collaborative communication Ability to work under pressure with multiple deadlines and priorities Strong problem-solving skills, critical thinking skills, and organizational skills US work authorization Someone who embodies “Being Oaky”
What does being Oaky look like?
Radiating positive energy Assuming good intentions Creating an unmatched patient experience Driving clinical excellence Taking ownership and delivering results Being relentlessly determined Why Oak Street Health? Oak Street Health is on a mission to rebuild healthcare as it should be, providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient communities, and focused on the quality of care over volume of services. We are an organization on the move! With over 200+ locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody Oaky values and passion for our mission. Oak Street Health
Benefits
Mission-focused career impacting change and measurably improving health outcomes for Medicare patients Paid vacation, sick time, and investment/retirement 401K match options Health insurance, vision, and dental benefits Opportunities for leadership development and continuing education stipends New centers and flexible work environments Opportunities for high levels of responsibility and rapid advancement Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The Typical Pay Range For This Role Is
$43,888.00 - $93,574.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great Benefits For Great People
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 12/31/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Seniority level
Seniority level Entry level Employment type
Employment type Full-time Job function
Job function Finance and Sales Industries Hospitals and Health Care Referrals increase your chances of interviewing at Oak Street Health, part of CVS Health by 2x Get notified about new Compliance Auditor jobs in
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Health Plan Compliance Auditor
role at
Oak Street Health, part of CVS Health 3 days ago Be among the first 25 applicants Join to apply for the
Health Plan Compliance Auditor
role at
Oak Street Health, part of CVS Health Get AI-powered advice on this job and more exclusive features. At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Role description: The Associate, Delegation Compliance supports compliance activities for Oak Street Health’s internal care management and utilization management teams. They partner with operational leadership to implement and monitor ongoing quality improvement activities, lead external compliance and accreditation survey processes, and leverage program knowledge and analytical skills to effectively coordinate all compliance activities.
Responsibilities
Possesses and demonstrates knowledge of CMS, contractual, accreditation, federal, state, and business requirements for assigned programs, and ensures compliance with program requirements Collaborates with leadership to develop, implement, and maintain policies and procedures for assigned programs Collaborates with leadership to develop and execute auditing and monitoring tools utilized for staff and program audits Collaborates with payers, serves as SME for compliance-related activities Contributes to reports used by internal and external leadership Provides input and valuable feedback on auditing results, trends and improvement activities Recommends process improvement, interventions, and assists with implementation Develops and revises training materials based on QA results Analyzes processes and key performance indicators to assess compliance risk, internal control, and overall effectiveness and efficiency Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practices Develops Corrective Action Plans (CAPs) and Performance Improvement Plans (PIPs) and is accountable for the adequacy of operational responses and ongoing monitoring Performs other job duties, as assigned.
What We’re Looking For
Bachelor’s degree in Healthcare Administration, Compliance, related field, or equivalent experience 1-2 years of compliance experience dealing with care management requirements, utilization management requirements, auditing, reporting processes, action plans, and compliance training preferred Strong understanding of healthcare laws, NCQA requirements, and Medicare Part C regulatory compliance in a managed care organization or hospital health care system setting Experience working with regulators on compliance audits Ability to work independently and with others Experience in building and supporting strong teamwork and collaborative communication Ability to work under pressure with multiple deadlines and priorities Strong problem-solving skills, critical thinking skills, and organizational skills US work authorization Someone who embodies “Being Oaky”
What does being Oaky look like?
Radiating positive energy Assuming good intentions Creating an unmatched patient experience Driving clinical excellence Taking ownership and delivering results Being relentlessly determined Why Oak Street Health? Oak Street Health is on a mission to rebuild healthcare as it should be, providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient communities, and focused on the quality of care over volume of services. We are an organization on the move! With over 200+ locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody Oaky values and passion for our mission. Oak Street Health
Benefits
Mission-focused career impacting change and measurably improving health outcomes for Medicare patients Paid vacation, sick time, and investment/retirement 401K match options Health insurance, vision, and dental benefits Opportunities for leadership development and continuing education stipends New centers and flexible work environments Opportunities for high levels of responsibility and rapid advancement Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The Typical Pay Range For This Role Is
$43,888.00 - $93,574.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great Benefits For Great People
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 12/31/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Seniority level
Seniority level Entry level Employment type
Employment type Full-time Job function
Job function Finance and Sales Industries Hospitals and Health Care Referrals increase your chances of interviewing at Oak Street Health, part of CVS Health by 2x Get notified about new Compliance Auditor jobs in
Chicago, IL . Sanctions Operations Analyst, Compliance
Chicago, IL $88,000.00-$126,000.00 6 days ago Chicago, IL $122,400.00-$168,300.00 2 weeks ago Compliance Specialist - Enhanced Diligence
Chicago, IL $210,000.00-$275,000.00 3 weeks ago Senior Compliance Officer (or Compliance Officer)
Chicago, IL $220,000.00-$280,000.00 1 week ago Chicago, IL $69,000.00-$113,850.00 2 weeks ago Chicago, IL $80,000.00-$95,000.00 6 months ago Park Ridge, IL $58,000.00-$120,000.00 2 weeks ago Chicago, IL $69,000.00-$113,850.00 2 weeks ago Greater Chicago Area $100,000.00-$145,000.00 5 days ago Chicago, IL $67,000.00-$99,000.00 2 weeks ago Compliance Officer (Testing), Hybrid- Chicago, IL)
Chicago, IL $86,000.00-$107,000.00 2 months ago Elk Grove Village, IL $52,000.00-$58,000.00 3 days ago Senior Manager of Compliance Communications
Wheaton, IL $140,000.00-$170,000.00 1 month ago Chicago, IL $140,000.00-$229,000.00 2 weeks ago Chicago, IL $80,000.00-$100,000.00 3 weeks ago Evanston, IL $90,000.00-$180,000.00 4 days ago Chicago, IL $79,800.00-$103,966.00 5 days ago ACH and Payments Compliance and Governance
Chicago, IL $90,000.00-$100,000.00 2 weeks ago Chicago, IL $75,000.00-$85,000.00 4 weeks ago Chicago, IL $100,500.00-$173,250.00 3 weeks ago Chicago, IL $70,251.00-$76,490.00 1 month ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr