Compliance Analyst- Fraud Intake & Triage Analyst

It's fun to work in a company where people truly BELIEVE in what they're doing!

We're committed to bringing passion and customer focus to the business.

Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services.

Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve. (learn more at www.pplfirst.com).

Duties & Responsibilities:

• Reviews operational performance against contractual and regulatory requirements and report on levels of contract compliance.

• Supports the development and application of compliance policies, standards, training, and processes.

• Assists with internal and external auditing efforts, including preparation and organization of audit documentation, as well as collaborating with cross-functional teams to address audit findings. Assists in developing and executing reviews/audits of operations, report executive summary to appropriate parties, and assists with requests from external parties in relation to program audits.

• Oversee reporting of suspected Medicaid Fraud, Waste and Abuse (FWA), and physical Abuse, Neglect, and Exploitation (ANE) cases.

• Assists with security/privacy incidents, including investigation, root-cause analysis, remedial actions, and incident close-out.

• Presents sound conclusions based on data analysis and communicate findings effectively, both in person and in writing.

• Assists in defining, documenting, and improving business processes or operational efficiencies. Uses problem solving approach to address issues and follows, critically evaluates, and improves upon current processes.

• Prepares, manages, and documents daily correspondence, written, verbal and e-mail, to clients and their stakeholders. Responds to inquiries and questions from various stakeholders.

• Assists in managing projects, risk assessments, and ensuring deliverables are met on an ongoing basis.

• Conducts policy and other types of research.

• Participate in proposal development teams, including writing sections, coordinating efforts, and preparing proposal submissions.

• Works within a team to accomplish other duties to meet necessary deadlines. Works with management on other compliance-related matters.

Required Skills:

• Strong communication, analytical, interpersonal, organizational, research, presentation, and problem- solving skills.

• Attention to detail and self-motivated with an ability to work independently and in a team environment.

• Proficiency in Microsoft Office technology.

• Ability to interact with various levels of management and with clients

Qualifications:

Education & Experience:

• Bachelor’s degree is required.

• BS/BA in business administration, finance, accounting, information systems, healthcare administration or other related area of concentration.

• 2+ years of relevant work experience.

• Preferred experience with Medicaid and managed care organizations.

• Prior compliance, risk management and/or audit experience favorable.

Working Conditions:

• Remote

Compensation Range: $70,000-$80,000

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified

PPL is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PPL will not tolerate discrimination or harassment based on any of these characteristics.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!