FirstBank Jobs

JOB REQUIREMENTS: Willingness to learn and execute on audit deliverables for performance measurement compliance programs, in alignment with standards from National Committee for Quality Assurance (NCQA), URAC, Centers for Medicare and Medicaid Services (CMS) and other partners. Interprets data and audit specifications to assist clients in meeting their annual reporting requirements. Assists Service Line leads with deploying annual audit programs. Leads or supports client audits as necessary. Serves as a backup to Service Line leads as needed. Communicates audit program changes to MetaStar IT staff to ensure audit program changes are updated in the MetaStar Portal. Communicates with health plans regarding audit updates and requirements. Maintains online audit folder structure. Contributes to annual documentation updates for audit and tool changes. Communicates routinely with the Vice President of Commercial Services regarding audit progress, issues, other departmental work timelines, priorities, etc. Participates in cross-departmental teams in support of company-wide initiatives. Promotes positive internal and external communication and positive teamwork. Works independently with a high degree of autonomy. Performs all other duties as assigned to support the team and organization, ensuring flexibility and adaptability to changing priorities and needs. ***** OTHER EXPERIENCE AND QUALIFICATIONS: Familiarity with HEDIS Compliance Audits Minimum of 2 years of relevant experience with a healthcare organization, healthcare software vendor, regulatory organization, PBM or similar entities. Demonstrated experience and proficiency with MS Office applications. Excellent analytical skills and ability to manage and work with large data sets. Proficiency in data manipulation (filtering, summing, etc.). Leadership Skills: Relationship management, project management, time management, critical thinking, strong communication with internal and external customers, and effective writing skills. Ability to interpret specifications to IT personnel. Ability to work independently and within a team structure. Valid driver\'s license or ability and means to travel as required. Interest and availability for in-state and overnight travel (10% of the time). Experience with any of the following: URAC Data Validation, Risk Adjustment Data Validation, Medicare Data Validation Part C & D is preferred Experience with process improvement and/or quality improvement methodologies is preferred ***** APPLICATION INSTRUCTIONS: Apply Online: www2.appone.com/Search/Search.aspx?ServerVar=metastarinc.appone.com Qualified females, minorities, and special disabled veterans and other veterans are encouraged to apply.