Healthcare Analyst/Auditor

Our client is a publically traded entrepreneurial organization which has grown to be a leader throughout the healthcare industry since the early 1980's. They are considered a pioneer in the design and implementation of consumer driven plans - paying over $1 billion in claims each year. 

We are seeking an individual that will be responsible for auditing provider network relationships as well as data integrity audits and demographic analysis and contract information. They will also have some responsibilty for network operations. Other responsibilities will be executing audit plans, timelines, and reports for key relationships, audits for performance repricing strategies and accuracy, provider file input, preparation of reports and audit findings along with recommendations for process improvements. This position reports to an AVP of Network Operations.

The right candidate will have two to three years of auditing experience within the healthcare industry as well as experience with a claims payor or provider along with a working knowledge of managed care, provider networks and insurance operations.