Providence Jobs

Job Information

Providence Medicare Audit Analyst in Beaverton, Oregon


Providence St. Joseph Health is calling a Medicare Audit Analyst to our location in Beaverton, OR.

We are seeking a Medicare Audit Analyst who will be directly responsible for Providence Medicare Advantage's plan-wide audit program and assists in the administration of the compliance program. The Medicare Audit Analyst reports directly to the Mgr. - Medicare Compliance Program. The Medicare Audit Analyst is responsible for conducting audits in accordance with the Centers for Medicare and Medicaid Services (CMS) requirements, the annual audit work plan/dashboard and as assigned by the Mgr. - Medicare Compliance Program, to support and maintain plan-wide compliance initiatives, policies and procedures.

In this position you will have the following responsibilities:

  • Responsible for the Medicare Advantage Auditing and Monitoring Program.

  • Researches compliance findings and coordinates the development of corrective action plans.

  • Responsible for oversight of departmental monitoring and auditing schedule to ensure compliance with CMS requirements.

  • Accountable for developing annual audit dashboards, audit risk assessments and audit metrics.

  • Independently audits and develops work plans and/or corrective action plans as required and audit results/CMS mandates.

  • Accountability as the primary audit liaison between Regulatory Compliance and Government Affairs and the departments.

  • Assists the Mgr. - Medicare Compliance Program as needed regarding the Auditing and Monitoring Program.


Required qualifications for this position include:

  • 2 years health plan operations experience or health services experience with Medicare programs, or specifically relevant experience with compliance requirements for Medicare programs, or other relevant experience such as work in compliance, legal and/or other related positions.

  • Experience with one or more of the following: Process improvement activities; policy/procedure development; report writing; written customer communications.

  • 6 months Medicare Advantage auditing experience.

Preferred qualifications for this position include:

  • Bachelor's Degree or equivalent education/experience.

  • Strong knowledge of Providence's Medicare Advantage's Medicare programs and related operations.

About Providence in Oregon

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

"Providence will provide the best care and service to every person, every time."

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

For information on our comprehensive range of benefits, visit:

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Compliance

Location: Oregon-Beaverton

Req ID: 273872