Monitor and analyze regulatory/accreditation/business requirements to invoke recommendations for program and/or policy changes as appropriate for various lines of business.
Lead/coordinate activities, which include internal audits, quality assurance control, quality improvement, provider satisfaction and department policies and procedures, to meet and/or maintain regulatory/accreditation/line of business requirements.
Serve as a resource to internal and external staff regarding issues relating to administrative policies and procedures, medical policies, and researching and resolving problems.
Edit all documentation generated by unit e.g., QIAs, reports, executive summaries, presentation materials, workplans, evaluations, annual plans, policies and procedures, minutes, agendas, provide feedback, and develop/generate monitoring reports/tools.
Coordinate/schedule training opportunities and develop/present related reports and various documentation.
Coordinate, support and document various department activities to ensure deliverables are completed by due date.
Perform other duties (e.g., attend meetings) as assigned.

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Medical Management Compliance Analyst at HMSA

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