Health Care Compliance Specialist (Secret Shopper)

This is a hybrid position based in the Delray Beach area, requiring regular local travel. Candidates must reside within Delray Beach area and be comfortable with travel throughout the region. When not in the field, the role offers the flexibility to work remotely. This is a great opportunity for someone seeking a flexible job! 

Myers and Stauffer is seeking an observant, detail-oriented, and reliable Compliance Specialist to support the Network Adequacy team. This position involves evaluating adequate health plan provider networks through onsite visits, telephonic surveys of healthcare providers, and assessing the accuracy of provider directories; ultimately helping to improve patient access and satisfaction.

Essential Functions and Primary Duties

• Conduct onsite and telephonic surveys (as a "secret shopper") to assess the availability, and accessibility of healthcare providers.

• Ability to use survey platform and call center tools. 

• Follow review surveys and checklists and fully document responses and observations accurately.

• Maintain detailed, organized records and follow reporting timelines. 

• Work with the team to improve processes, share insights, and develop recommendations for monitoring access to care.

• Maintain professional behavior while conducting assessments in both onsite and telephonic settings.

• Additional responsibilities as assigned. 

Preferred Qualifications 

• Proficiency in data entry tools and Microsoft Office Suite (Word, Excel).

• Strong organizational and time management skills to manage assignments effectively and meet deadlines.

• Strong written and verbal communication skills.

• Bilingual in English and Spanish. 

• Reliable transportation to conduct onsite evaluations. 

• Ability to travel up to 60% of time based on client and business needs. 

• Ability to work flexible hours to accommodate various assignments.

• Ability to work with minimal supervision while fulfilling all obligations.

• Ability to adhere to strict confidentiality guidelines and maintain professionalism.

• Willingness to provide unbiased feedback based on observations rather than personal opinions or biases.

• Familiarity with healthcare networks, provider enrollment processes, and/or patient services.

• Prior experience in any of the following roles: secret shopper, healthcare compliance, auditing, program integrity, health plan provider/member enrollment, customer care call center.

   

Minimum Qualifications

•  High School diploma or GED

Myers and Stauffer LC is a certified public accounting and health and human services consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45+ years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 21 offices and have over 900 associates nationwide.

At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government health and human service clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team. Our firm takes pride in the welcoming and collaborative culture we have throughout our offices.  We are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing.

What We Offer:

We understand that changing or learning a new industry can discourage strong candidates from applying. Please do not hesitate to apply, as you may be the right fit for this position or another position we have open.