Public Consulting Group LLC (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986, PCG employs approximately 2,000 professionals throughout the U.S.—all committed to delivering solutions that change lives for the better. The firm is a member of a family of companies with experience in all 50 states, and clients in six Canadian provinces and Europe. PCG offers clients a multidisciplinary approach to meet challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit www.publicconsultinggroup.com.

*Please note: This role is Remote.

Compliance Analysts are integral members of PCG’s Medicaid School-Based Services (SBS) Center of Excellence (COE).   As part of the Program Integrity functional area, this position will be responsible for assisting in both internal and external audits and reviews as well as client monitoring reviews for both the Medicaid Administrative Claim (MAC) and Fee-for-Service (FFS) Programs. While this is an internal facing position there may be some interaction with clients during the process to receive and review support documentation. The Compliance Analyst role will work alongside other Compliance Analysts and report directly to their assigned Program Integrity Lead.

Responsibilities:

The Compliance Analyst can expect to play an active role in a wide range of work assignments around the review of our MAC and FFS programs including, but not limited to:

• Assist in the collection and review of documentation requests from outside auditors
• Ongoing monitoring of internal processes for compliance with process, documentation, and quality standards (including periodic claims review as needed)

• • Critical thinking and reviews skills to not only check if a process was completed but reviewing to be able to verify that processes and procedures were accurately followed and identify corrective actions in cases where those were not followed

• Assist in the development of the annual compliance review plan
• Assist in the development of process improvement areas that arise from reviews
• Assist in the collection and review of client data necessary to meet contractual program monitoring requirements
• Drafting of monitoring review reports that will be sent to clients
• Opportunity to develop training materials and deliver trainings to internal teams related to Program Integrity including but not limited to: New hire trainings, annual trainings, and ad-hoc training requests
• Opportunity to learn compliance elements of both MAC and FFS programs
• Conduct proactive internal reviews of FFS or MAC program elements as requested
• Collaborate across COE lanes in support of Program Integrity
• Opportunity to participate in activities that provide analysis that is utilized to drive risk assessment decisions

*Please note: This role is Remote.

Required Skills 

• Effective communication skills (presentation, facilitation, and written)   
• Relationship building (with peers, staff, and leadership)   
• Ability to develop competencies across all PI COE activities
• Organization, planning, and time management skills 
• Meticulous attention to detail 
• Problem solving skills
• Ability to use sound judgment in completing tasks and to seek guidance from PI Leads when needed 
• Ability to learn PCG’s proprietary Medicaid SBS systems

Preferred Work Experience and Education 

Education

• Bachelor’s degree or equivalent combination of education and experience

Experience

• 1 + years of experience as a compliance, and/or risk, and/or governance, and/or quality control analyst in an internal company facing and/or external client project role
• Prefer experience in healthcare reimbursement
• Strong preference of school-based Medicaid experience
• Experience performing internal and/or external compliance reviews and follow-up reviews in areas including but not limited to: contracts, records, policies, procedures, and client monitoring reviews
• Working knowledge of procedures for internal, and/or external, and/or payroll, and/or compliance audits
• Track record of working independently and consistently to achieve results
• Proficiency in MS Office products, including PowerPoint, Excel and Word
• Experience using Asana or comparable task management / project management tool

Compensation for roles at Public Consulting Group varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, PCG provides the following reasonable range of compensation for this role: $55,000 - $70,000. In addition, PCG provides a range of benefits for this role.

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.