Healthcare Business Analyst

This position will require being on-site 1 day a week, in either the Chicago or Washington, DC office. This position will support the Part D Medicare Compliance Officer. Preference will be given to candidates with experience in Medicare Programs. Designs and documents business process requirements for all related business, financial, and operational systems critical to core business functions within FEP for support of the Medicare Prescription Drug Program, and other Medicare programs. This may require the Business Analyst to research and analyze data in support of business functions, process knowledge, and systems requirements. Recommends new or improvements to existing business and operational processes and procedures. Manages projects to build a Medicare Compliance Program. Manages compliance program auditing and monitoring activities. Assists with audit readiness. This person should have 7 years’ experience in the health payer industry – Blues or FEHBP experience desirable. Experience in Medicare Program Audits or Medicare CPE Audits is desirable. Experience with Compliance Programs is preferred.

Key Responsibilities

compliance training tracking

auditing and monitoring compliance program

monthly exclusion check monitoring

updating policies and procedures

compliance hotline monitoring

compliance program communications

compliance committee meetings

compliance program workplan

HPMS memo review and analysis

compliance program liaison with FEP

Medicare Compliance shared mailbox owner

attend monthly MAPD Plan calls

assist with Compliance Program audit readiness

Ability to Commute:

North Chicago, IL 60064 (Required)

Ability to Relocate:

North Chicago, IL 60064: Relocate before starting work (Preferred)

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