Business Analyst – Program Integrity Vendor Audits (Remote)

City/State

Work Shift

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.

Key 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.

Preferred Skills:

• 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

• Bachelor's Degree (Required)

• No specific certification or licensure 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.

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Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.