A resume and cover letter must be submitted along with your application.
The Office of Management and Enterprise Services (OMES) is a government agency providing services to other Oklahoma government agencies. We work toward the goals of capitalizing on available resources, continuing to seek cost saving opportunities and elevating our level of service. Our mission is to be a “FAST” agency: Flatter, Agile, Streamlined, and Technology-enabled.
The Employees Group Insurance Division is seeking a full time Compliance Analyst for our Oklahoma City location. This is an Unclassified position within Oklahoma State Government. In addition to a generous Benefits Packet the annual salary for this position is up to $40,800.00 based on education and experience.
This position is assigned responsibilities for data analysis and Medicare D reporting oversight as required by federal contract and annual Data Validation Audits; review and preliminary investigations of potential fraud cases as required under the Medicare Part D contract with CMS; and preliminary investigation of potential privacy breaches under HIPAA/HITECH.
Medicare contract data validation:
*Analyze reports against ESI raw data to validate reporting records.
*Download, permanently archive Part D reports; provide notices to appropriate individuals.
*Handle loading and reporting for Part D data validation audits.
*Analyze Clinical Sub Committee packets and data that is reported to CMS.
*Documentation of all processes required under the CMS Data Validation Audit protocols.
*Investigation, and write-ups (including preparing required member notifications) of detected HIPAA violations.
Fraud, Waste and Abuse (FWA):
*Investigation, resolution and write up of reported FWA.
Assisting in the development of annual HIPAA and FWA training for division and agency staff.
Supervisory Responsibilities: None.
Knowledge, Skills and Abilities:
*Ability to analyze data using Microsoft Excel and Access for trends and discrepancies;
*Ability to interpret federal guidelines;
*Ability to summarize results of investigations;
*Must be able to document procedures into policies.
Education and Experience:
(4) years experience in insurance; business administration; or a closely related field
An equivalent combination oeducation and f experience.
OMES is an Equal Opportunity Employer. Reasonable accommodation to individuals with disabilities may be provided upon request.