Business Analyst – Program Integrity Vendor Audits (Remote)

🌍 Remote, USA 🚀 Full-time 🕐 Posted Recently

Job Description

We are looking for a meticulous and analytical Business Analyst to oversee the management of third-party vendors. This role will be responsible for analyzing vendor performance, identifying cost-saving opportunities, and is critical in ensuring vendor compliance with contractual, regulatory, and operational standards. The ideal candidate will bring strong analytical skills, audit/claims experience, and a collaborative mindset to support risk mitigation and performance improvement across the vendor landscape.

    Key Responsibilities:
  • Analyze audit findings and vendor performance data to identify trends, risks, and improvement opportunities.
  • Data extraction & Analysis
  • Regulatory Reporting & KPI Development
  • Serve as a liaison between vendors and providers to resolve issues and improve service delivery.
  • Track and evaluate vendor performance using KPIs and SLAs.
  • Conduct regular vendor reviews and audits to ensure compliance and quality standards.
  • Evaluate vendor adherence to Business Associate Agreements (BAAs), SLAs, and quality standards.
  • Recommend enhancements to vendor audit frameworks, tools, and documentation practices.
  • Contribute to the development of policies and procedures for vendor oversight and governance.
  • Support continuous improvement initiatives in vendor lifecycle management.
  • Maintain documentation of audit procedures, findings, and follow-up actions.
  • Contribute to the development of vendor audit policies and workflows.
    Preferred Skills:
  • Knowledge of Databricks
  • Knowledge of SQL
  • Experience in regulated industries (e.g., healthcare, finance, insurance).
  • Experience and/or knowledge of medical coding and inpatient auditing
    Education
  • Bachelor's Degree (Required)
    Certification/Licensure
  • No specific certification or licensure requirements
    Experience
  • 3+ years of relevant experience in business analysis, data reporting, or analytics (Required)
  • Must have 3+ years of experience in business analysis, auditing, claims, vendor management, or compliance.
  • Knowledge of business intelligence (BI) tools, SQL querying, and reporting software.
  • Required to have experience working with health insurance, claims data, and auditing claims data
  • Excellent written and verbal communication skills.

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$53,476.80-$89,128.00. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

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