Compliance Analytics Manager

Agency Dept of Health and Human ServicesDivision HEALTH BENEFITSJob Classification Title Business Systems Analyst II (NS)Position Number 65029285Grade NC19About Us The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.Description of Work The Compliance Analytics Manager oversees a team of analysts responsible for advancing automated data analysis initiatives that strengthen efforts to detect and reduce fraud, waste, and abuse within the Medicaid program. This position manages the use of current data analysis systems and recommends enhancements or alternative tools to improve program integrity outcomes. Working in coordination with Compliance Unit managers, this role identifies and analyzes key data to evaluate provider and recipient practices, leveraging queries and gap analyses to uncover potential risks.Key responsibilities include leading the development of the annual analytics workplan; coordinating review activities with the Medicaid Investigations Division (MID), health plans, internal DHB staff, and vendors; and overseeing the creation of analytic data packages for Medicaid investigations teams. The manager facilitates team meetings to develop relevant queries, reports, and process improvements, while fostering the team’s technical proficiency and use of analytic tools.This position also leads all aspects of personnel management, including recruitment, coaching, performance management, professional development, and, when necessary, disciplinary or termination actions. Through effective leadership and strategic oversight, the Compliance Analytics Manager ensures data-driven decision-making that supports the Division’s compliance and program integrity goals.Knowledge Skills and Abilities/Management PreferencesSalary Range: $64,621.00 – $113,088.00Recruitment Range: $64,621.00 – $93,516.00**POSITION IS A TIME-LIMITED, GRANT FUNDED FULL-TIME UNTIL — JUNE, 2028****Position is Exempt from the State Human Resources Act – G.S. 126**Candidates now meet the minimum qualifications of a position if they have the minimum education and experience listed on the vacancy announcement.The following Management Preferences are not required, but applicants that possess these skills are preferred:Thorough understanding of business systems theories, processes, and regulations, and their application to technology within relevant program areas.Comprehensive knowledge of business information systems, testing methodologies, and system analysis to support effective operations and decision-making.Proven ability to validate and ensure the reliability of data to support compliance reviews and potential legal proceedings.Skill in recognizing system limitations and developing solutions that enhance business process efficiency.Strong analytical, creative, and critical-thinking skills to evaluate complex situations and influence project direction.Position is funded in part through federal funds.**Position is eligible for a hybrid-teleworking schedule to include weekly onsite work hours**Posting closes at 11:59 p.m. the night before the end date.About the NC Division of Health Benefits:
The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget of over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.Compensation and Benefits: The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees. Visit website for .Supplemental Contact Information:The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: .DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.In accordance with the Governor’s , our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.Application Process
Be sure to complete the application in its entirety. Resumes will not be accepted in lieu of completing this application.Information should be provided in the appropriate areas, to include the following: Education, including high school and all degrees obtained, Work Experience, and Certificates & Licenses. It is critical to our screening and salary determination process that applications contain comprehensive candidate information.Answers to Supplemental Questions are not a substitute for providing all relevant information within the body of your application. To receive credit for the supplemental questions, you must provide supporting information within the “Work Experience” section of the application to support your answers.If multiple applications are submitted to an individual posting, only the most recent application received prior to the closing date will be accepted. Applications must be submitted by 5:00 PM on the closing date.Applicants may be subject to a criminal background check. All candidates selected for positions considered “Positions of Trust” will be subject to a criminal background check.Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. Upon the closing date, applications are “Under Review” and will be screened by Human Resources for qualified applicants. The hiring process may take several weeks.Degrees must be received from appropriately accredited institutions. Transcripts and degree evaluations may be uploaded with your application. The State of North Carolina/Office of State Human Resources uses the National Association of Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent.For a list of organizations that perform this specialized service, please visit the NACES membership website at .Degree/College Credit VerificationDegrees must be received from appropriately accredited institutions. Transcripts, degree evaluations and cover letters may be uploaded with your application.Veterans’ and National Guard PreferenceApplicants seeking Veteran’s Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications.Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application, if they are a current member of the NC National Guard in good standing.Applicants who are former members of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of their DD 256 or NGB 22, along with the state application.ADA Accommodations:Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.CONTACT INFORMATION: If there are any questions about this posting, please contact Talent Acquisition at . Resumes will not be accepted in lieu of completing this application.Minimum Education and Experience Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See for details.Bachelor’s degree from appropriately accredited institution in a discipline related to the area of assignment with three years of programmatic experience related to the area of assignment;ORan equivalent combination of training and experience.EEO StatementThe State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.Recruiter: Carole Cox-CarrollRecruiter Email: CAROLE.COX-CARROLL@DHHS.NC.GOV

State of North Carolina