UMass Med School Looking for Healthcare Auditor – REMOTE at Charlestown, MA  Full Time

GENERAL SUMMARY OF POSITION:

Under the general direction of the Senior Associate or designee, the Associate II will assist in the development of contracts with state agencies; both in and out of state.

MAJOR RESPONSIBILITIES:

Perform complex analysis in support of projects in and out of state
• Perform research & development analysis relevant to revenue management/enhancement projects as assigned
• Assist in the development of program expansion plans
• Assist in the development of presentations and the preparation of marketing materials to clients
• Support senior staff on site visits
• Participate in the development of agreements between public entities and the University
• Participate in Request for Information/Request for Proposal processes
• Participate in project forecasting and work on assigned financial analysis projects.
• Participate in presentations to staff regarding success, merits of initiative, etc.
• Research, develop, and prepare work and implementation plans in support of project and initiatives. Complete assigned projects from start to finish
• Assist in coordinating with subcontractors to obtain databases for various revenue initiatives
• Participate in training staff and clients (in and out of state) in types of reimbursable initiatives
• Provide technical support in the preparation of federal claims for reimbursement
• Coordinate communications with clients about status of their projects
• Prepare internal and external reports
• Participate in the Continuous Quality Improvement program
• Perform other duties as required.

REQUIRED QUALIFICATIONS:

• Masters degree and 3 -5 years of experience in a business related field, or equivalent experience
• Must have knowledge of State and Federal regulations as they apply to public assistance programs
• Demonstrated experience in computer based tools including spreadsheets and word processing
• Knowledge of accounting principles, budgeting, and computer reporting preparation
• Demonstrated project management skills.
• Ability to travel to off-site locations

GENERAL SUMMARY OF POSITION:

Under the direction of the Financial Compliance Unit (FCU) Director or designee, the Healthcare Auditor plays an integral role in program integrity and compliance by performing, and potentially overseeing, financial audits/reviews. This position will be vital in implementing auditing policies, procedures, and contractual obligations. The Healthcare Auditor will work both independently and within a team, interacting with a variety of healthcare providers, vendors and team members.

ForHealth Consulting is the consulting division of UMass Chan Medical School. The FCU, within CWM, performs financial audits and reviews of Nursing Facilities and Hospitals to ensure compliance with MassHealth provider, administrative, and billing regulations. The FCU also performs various tasks related to billing, reporting and financial reviews of other state government programs. FCU staff are primarily accountants, auditors and staff highly skilled in Access and Excel.

PREFERRED QUALIFICATIONS:

• Expertise in Hospital or Nursing Facility billing, accounting, or auditing
• Formal education in accounting
• CPA, or extensive accounting experience
• Exceptional knowledge of accounting principles and financial reporting
• Exceptional knowledge of MassHealth MMIS and claims systems
• Knowledge of Medicare payment systems
• Proficient in MS Access, Excel and MSOffice
• Strong quantitative and analytical skills
• Exceptional oral and written communication skills
• Exceptional organizational skills
• Excellent ability to self-motivate and self-direct
• Experience and high level of comfort with Zoom and MS Teams
• Ability to effectively work in a remote setting