Compliance Auditor

Job Description:

The Compliance Auditor executes the Corporate Compliance Program. They are responsible for reviewing and evaluating compliance issues/concerns within the organization. The position ensures that management and employees are in compliance with the rules and regulations of regulatory agencies, that company policies and procedures are being followed, and that behavior in the organization meets the AWPRx Standards of Conduct. The Corporate Auditor directs compliance issues to appropriate resources for investigation and resolution, and is not the final resource with which concerned parties may direct their communicate after other formal channels and resources have been exhausted. The Compliance Auditor acts as liaison to leadership by monitoring and reporting the results of the compliance/ethics efforts of the company and in providing guidance for the senior management team on matters relating to compliance. The Compliance Auditor submits recommendations to implement all necessary actions to ensure achievement of the objectives of an effective compliance program. 

Job Duties & Essential Functions:

Overviews

• Develops, maintains, revises, and tests policies and procedures for the general operation of AWPRx. Identifies potential areas of compliance vulnerability and risk; develops/implements corrective action plans for resolution of problematic issues, and provides general guidance on how to avoid or deal with similar situations in the future. 

Standards of Interaction

1. All documentation must be performed in ForceRx through ForceRx’s cases (tickets), articles (knowledge bank), and test plans. AWPRx will not accept word documents, excel reports, or emails as documentation if it is not produced in the ForceRx system.

One TIme Functions

Perform a comprehensive review of AWPRx’s policies and procedures. Areas will include (but are not limited to):

• HR Onboarding and Offboarding
• Disaster Recovery Plans
• Computer Asset Policies
• Ongoing Functions

Annually

• Reviews and updates AWPRx’s policies and procedures to ensure continuing currency and relevance in providing guidance to management and employees.

Semi-Annual

• Conducts reviews of all compliance issues/concerns within the organization to ensure that compliance issues are being appropriately evaluated, investigated, and resolved. 

Quarterly

• TBD

Monthly

1. Performs and documents tests of AWPRx’s controls to ensure that all scheduled and necessary checks are executed per AWPRx’s written policy and procedures. Functions to include working from the following Department Dashboards:

• Account Management Validating that the client report suite is functioning fully in the client portal.
• HR Reviewing all HR Employee Folder cases to ensure that documentation is thorough and complete
• Reviewing HR Reports to ensure that all user records are up to date
• IT Testing disaster recovery protocols documented in the Disaster Recovery Article to ensure that AWPRx’s backup hardware is fully functioning and that the protocol remains effective in a case of emergency.
• Operations Perform inventory on fixed assets to ensure that they are correctly identified, documented and maintained in ForceRx.
• Service Cloud, this Dashboards primary function is to present reports of Case ages and additional KPI based reports.
• Customer Service – Dashboard
• Call Center Metrics
• Repricing
• Accounting
• Clinical

1. Enhances AWPRx’s policies and procedures as needed based on AWPRx’s evolving needs.

Job Qualifications:

• Education: 
  • A Bachelor’s degree preferred, Master’s desired.
  • Certification: Licensed or Certified Risk Manager Preferred.
• Experience: 
  • A minimum of 10 years experience in a healthcare organization, to include demonstrated leadership. Familiarity with operational, financial, quality assurance, and human resource procedures and regulations is a must.
• Supervisory experience: N/A
• Other competencies or skills:
  • Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences.
  • Oral Expression — The ability to communicate information and ideas in speaking so others will understand.
  • Speech Clarity — The ability to speak clearly so others can understand you.
  • Problem Sensitivity — The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
  • Written Expression — The ability to communicate information and ideas in writing so others will understand.
  • Written Comprehension — The ability to read and understand information and ideas presented in writing.
  • Deductive Reasoning — The ability to apply general rules to specific problems to produce answers that make sense.
  • Inductive Reasoning — The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
  • Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.
  • Interacting With Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
  • Communicating with Persons Outside Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or email.
  • Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, email, or in person.
  • Establishing and Maintaining Interpersonal Relationships — Developing constructive and cooperative working relationships with others, and maintaining them over time.
  • Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems.
  • Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job.
  • Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.
  • Resolving Conflicts and Negotiating with Others — Handling complaints, settling
• Background Checks/Licensing Requirements: N/A