Sr. Clinical Compliance Analyst

This role will assist the Clinical Compliance Team in regulatory reporting and help to identify trends and opportunities within the department to streamline processes, and tools to help the team to become more efficient and to allow growth. This individual will closely work with the Clinical Compliance Managers within the department as well as key internal stakeholders, such as the Clinical operations team, and various teams in IT. A large part of the work will include generating regulatory reports, completing quality assessments as required by CMS/Medicare, NCQA and Health Plan SLA's, utilizing clinical skills and data analysis and manipulation.

We invite you to apply today and join us in shaping the future of healthcare!

Key Responsibilities:

• Collect and organize performance metrics to provide stakeholders with actionable insights that support accountability, identify trends, and inform task prioritization.
• Lead high-impact, cross-functional projects, including re-onboarding and implementation efforts in alignment with organizational objectives and delivery of measurable outcomes.
• Lead efforts to ensure data integrity by auditing and resolving moderate to high complex data quality issues with minimal oversight.
• Drive process improvement initiatives and own medium to large projects to enhance database functionality, address inefficiencies, and support organizational goals.
• Utilize advanced research and analytical skills to assess trends and ensure compliance with evolving policies or regulations.
• Act as a primary point of contact for escalated data issues and coordinate cross-functionally in conjunction with client efforts to address challenges and ensure system connectivity.
• Develop training materials, onboarding guides, and operational workflow documents to ensure consistent knowledge transfer across teams.
• Perform other job duties as assigned.
• Generate regulatory reports on a weekly, monthly, or quarterly cadence. Analyze data for logical inconsistencies and identify and correct data discrepancies.
• Work closely with Clinical Compliance Managers to provide accuracy in regulatory reporting, assist as needed with audit deliverables and case file selection, meeting CMS/NCQA and Health Plan SLA's

Required Qualifications:

• Active, unrestricted license required - RN, PT, OT or SLP.
• 4-6 years of clinical nursing or therapy experience.

Preferred Qualifications:

• Excellent analytical skills.
• Strong attention to detail
• Must be able to prioritize, plan and handle multiple tasks/demands simultaneously
• High proficiency in Microsoft Office applications, particularly Excel.
• Ability to manipulate data from various reports

Job Expectations:

• Willing to work additional or irregular hours as needed.
• Must work in accordance with applicable security policies and procedures to safeguard company and client information.
• Must be able to sit and view a computer screen for extended periods of time.

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WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace.

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

• Excellent medical, dental, and vision benefits
• Mental health benefits through TelaDoc
• Prescription drug coverage
• Generous paid time off, plus 13 paid holidays
• Paid parental leave
• 100% vested 401(K) retirement plans
• Educational assistance up to $2500 per year