Delegation Oversight Auditor (Hybrid - Troy, MI) - Health Alliance Plan
GENERAL SUMMARY:
This role is passionate about supporting the Vendor Management Office (VMO) as part of an effective Compliance program. The Compliance Program provides a framework to continually evaluate, monitor, and report performance and risk associated with subcontractors through a coordinated and consistent approach. This position is tasked with maintaining key vendor management data and documenting compliance review activities and findings. This role will be the key driver in maintaining internal regulatory governance and metrics around evaluation for subcontractors and other risk-identified vendors and ensuring annual audits and monitoring exercises are completed accurately, timely and reported per the compliance audit plan. Serve as corporate compliance representative to the subcontractors. Develops and implements audit procedures, manages audit data, outcomes, and follow-up activities, and performs documentation and operational risk assessments to identify areas for process improvement. Drives implementation of the improvements to achieve efficiencies and eliminate redundancy. Responsible for development of reports, work instructions and work programs related to compliant audit processes. Identify risk areas or trends to be reviewed for audit plan and as needed, based on external focus areas, including identification of root causes. Works closely with leadership to promote and administer subcontractor audit activities.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
- Identify regulatory risks, develop risk mitigation strategies, and document findings remediation through closure.
- Based on reviews and audits, works collaboratively with the subcontractor to support the design and implementation of corrective action plans, education, standard operating procedures, and system improvements.
- Help establish a consistent and repeatable process of subcontractor assessments and risk oversight.
- Educate and consult business stakeholders in developing and continuously improving the understanding of subcontractor risk and strategies to mitigate it.
- Execute locally, the global corporate standards to satisfy regulatory requirements around data privacy and sharing.
- Interact directly with subcontractors, as needed, to ensure the appropriate information is gathered and assessed prior to onboarding approval.
- Develop communications, as appropriate, to ensure processes and subcontracting regulatory policies are understood by internal and external stakeholder base.
- Provide strategic level thinking, subcontractor management leading practices, and continuous improvement ideas to ensure best in class processes.
HAP Pay Grade: 26
EDUCATION/EXPERIENCE REQUIRED:
- Bachelor's degree preferred. In lieu of a degree, six (6) years of Health Plan operational experience may be considered.
- Minimum of three (3) years of experience working in a Managed healthcare organization or health system’s Risk function or 3rd Party Oversight.
- Strong communication, problem solving, decision making and organizational skills necessary.
- Strong relationship building and conflict management skills are required.
- Must be results focused with the ability to work in an autonomous environment.
- Experience working with Federal and State Health programs.
- Experience working with commercial insurance programs.
Overview
HAP is a Michigan-based, nonprofit health plan that provides health coverage to individuals, Â Â Â Â Â companies and organizations. A subsidiary of Henry Ford Health System, we partner with doctors, employers and community groups to enhance the overall health and well-being of the lives we touch. With more than 1,100 dedicated and passionate employees, our goal is to make health care easy for our members.
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Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a
$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites
including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and
other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system
now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one
of the nation’s oldest physician groups. An additional 2,200 physicians are also affiliated with the
health system through the Henry Ford Physician Network. Henry Ford is also one of the region’s Â
major academic medical centers, receiving between $90-$100 million in annual research funding and
remaining Michigan’s fourth largest NIH-funded institution. Also an active participant in medical
education and training, the health system has trained nearly 40% of physicians currently practicing
in the state and also provides education and training for other health professionals including nurses,
pharmacists, radiology and respiratory technicians. visit HenryFord.com.
Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Â Henry
Ford Health System has a new approach for its employee benefits program - My Choice
Rewards. Â My Choice Rewards is a program as diverse as the people it serves. Â There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. Â As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness
and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other
benefits and services. Employee's classified as contingent status are not eligible for benefits
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.