Deep understanding of medicare part c & d standards
Experience managing fdrs and issuing caps
The role requires ensuring that vendors deemed as First Tier, Downstream and Related Entities maintain compliance with all applicable State and Federal regulations
Job Summary
The role requires ensuring that vendors deemed as First Tier, Downstream and Related Entities maintain compliance with all applicable State and Federal regulations.
Responsibilities include conducting regular audits, creating scorecards, and issuing Corrective Action Plans to address deficiencies.
The company offers a total rewards package including health benefits, stock options, bonus eligibility, and a $100 monthly mobile or internet stipend.
Matching Summary
The role requires ensuring that vendors deemed as First Tier, Downstream and Related Entities maintain compliance with all applicable State and Federal regulations.
Salary
Base: $75,000-$115,000; Bonus/Equity: Stock options for all employees; Benefits: Employer sponsored health, dental, vision, PTO, 401K
Skills & Requirements
Must-have
2-5 years healthcare auditing experience
Deep understanding of Medicare Part C & D standards
Experience managing FDRs and issuing CAPs
Ability to conduct desktop and onsite audits
Nice-to-have
Proficiency in Google Workspace and Slack
Interest in applying Generative AI to audit tasks
Strong project management in remote-first environment
Key Requirements
2–5 years of healthcare auditing or insurance operations experience
Proven experience managing First Tier, Downstream, and Related Entities (FDRs)
Demonstrated ability to execute full audit process from desktop/onsite to reporting