Business Analyst - Program Integrity Vendor Audits (Remote)

Remote Full-time
About the position Overview We are looking for a meticulous and analytical Business Analyst to oversee the management of third-party vendors. This role will be responsible for analyzing vendor performance, identifying cost-saving opportunities, and is critical in ensuring vendor compliance with contractual, regulatory, and operational standards. The ideal candidate will bring strong analytical skills, audit/claims experience, and a collaborative mindset to support risk mitigation and performance improvement across the vendor landscape. Responsibilities • Analyze audit findings and vendor performance data to identify trends, risks, and improvement opportunities. • Data extraction & Analysis • Regulatory Reporting & KPI Development • Serve as a liaison between vendors and providers to resolve issues and improve service delivery. • Track and evaluate vendor performance using KPIs and SLAs. • Conduct regular vendor reviews and audits to ensure compliance and quality standards. • Evaluate vendor adherence to Business Associate Agreements (BAAs), SLAs, and quality standards. • Recommend enhancements to vendor audit frameworks, tools, and documentation practices. • Contribute to the development of policies and procedures for vendor oversight and governance. • Support continuous improvement initiatives in vendor lifecycle management. • Maintain documentation of audit procedures, findings, and follow-up actions. • Contribute to the development of vendor audit policies and workflows. Requirements • 3+ years of relevant experience in business analysis, data reporting, or analytics (Required) • Must have 3+ years of experience in business analysis, auditing, claims, vendor management, or compliance. • Knowledge of business intelligence (BI) tools, SQL querying, and reporting software. • Required to have experience working with health insurance, claims data, and auditing claims data • Excellent written and verbal communication skills. Nice-to-haves • Knowledge of Databricks • Knowledge of SQL • Experience in regulated industries (e.g., healthcare, finance, insurance). • Experience and/or knowledge of medical coding and inpatient auditing Benefits • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down - $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development • Pet Insurance • Legal Resources Plan • Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Apply tot his job
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