Role Description The Group Health Training and Auditing Specialist (GH Trainer) is responsible for delivering structured training and ongoing education to new hires and current staff, while identifying opportunities for learning, growth, and remediation. This role plays a critical part in improving employee performance, job satisfaction, and client outcomes by monitoring trends such as clarifications, turnaround times (TAT), and overturn rates. - Onboard and train all new QA hires. - New QAs will be ready for integration into the ops team when the following criteria are met: - Proficiency on one core client (≤ 2% clarification rate) - Division 1: HCSC - Division 2: BCBS MN - Division 3: Optum - Daily output of ≥ 5 cases - Collaborate on the review of daily operational reports (e.g., outcome reports, TAT, operational synopsis, employee goals). - Serve as a resource for team members regarding operational questions, concerns, and problem-solving. - Provide backup support to QA Supervisors as needed (e.g., invoicing, board balance). - Maintain weekly clarification tracker; identify QAs with opportunities for additional training or feedback. - Participate in client calls. - Lead bi-weekly Clarification/TAT review meetings: pull data, facilitate discussions, and issue remediation plans. - Conduct regular MFR (member-friendly rationale) Workshop training sessions. - Develop onboarding agendas in consultation with Ops Leadership. - Identify and schedule training opportunities/meetings. - Coordinate and track annual client regulatory training requirements. - Support regulatory accreditation audits (e.g., NCQA, URAC). - Provide backup support to GH Auditor in performing client collaboration audits (e.g., BCBSMN monthly, HCSC quarterly and annual). - Update and maintain severity and client-change trackers. - Create and maintain training documentation. - Collaborate on remediation plans for employees. - Provide reviewer training when a Medical Director is unavailable; escalate issues to Medical Directors when appropriate. - Partner with managers and supervisors to support 90-day reviews, annual evaluations, and PIPs. Performance Metrics: - Audit Success: Measured by clarification rates, audit results, and daily/monthly TAT. - Remediation Effectiveness: Measurable performance improvement within defined timelines. - Training Success: Evaluated through 90-day and annual employee reviews, and check-ins with new hires (daily, weekly, monthly). Other duties & special projects, as assigned and based on business needs. Qualifications - RN or LPN license required. - Strong background in clinical operations, training, or quality assurance. - Extensive experience in utilization review, with a strong background in health plan practices. - Experience navigating CMS requirements, health plan criteria, and nationally recognized guidelines such as MCG and InterQual. - Proficient in rationale writing and translation to patient-friendly language. - Excellent communication, coaching, and mentoring skills. - Ability to analyze data and identify trends to drive performance improvements. - Skilled in client collaboration and escalation management. - Proficiency with Google Suite, communication platforms, and related applications. Requirements - Preferred Experience Includes: - Benefit Denials - Medical Necessity Reviews - EIU Reviews - Criteria-Only Reviews - Formulary Exception Reviews - Quantity Limit Reviews - Step Therapy Reviews - Inpatient vs Observation Reviews - Level of Care Reviews - Claims Reviews - Payment Integrity Reviews - DRG Validation - Quality of Care Reviews - Fraud, Waste, and Abuse (FWA) Reviews Benefits - Comprehensive benefits package including medical, dental, and vision coverage for you and your family. - Voluntary life insurance options for you, your spouse, and your children. - Other voluntary benefits including hospital indemnity, critical illness, accident indemnity, and pet insurance plans. - Basic life insurance, short-term disability, and long-term disability coverage at no cost. - Generous paid time off policy. - 401k plan with a company match. - Apple equipment and a media stipend for remote workspace.

• Conducts insurance policy audits for Worker’s Compensation, Auto and General Liability policies • Audits the policyholder’s records according to client company standards • Schedules appointments with the insured to be audited • Obtains necessary documentation for audits while adhering to customer requirements and quality standards

• Support clients through their assessment process with us to achieve ISO standards • Take clients through the audit process, prepare a report, and present findings • Assess a wide range of clients, from very small to global brands in different industry sectors • Conduct on-site and remote audits

Role Description The Audit Senior will play a critical role in engagement teams performing attestation engagements for clients in a wide variety of industries and of all sizes. Depending on the size and complexity of the engagement, Audit Seniors may lead the engagement team or function in a team led by an Audit Supervisor or Manager. Our attestation and assurance services strive to go beyond just a compliance function. We believe in strong client relationships and serve as a business advisor throughout the year. In this role, you must be comfortable working independently and collaborating on a team. The Audit Senior must be ready to be client facing at any time. This position involves critical thinking and attention to detail, with the ability to meet deadlines. Duties - Build and nurture relationships with clients on a level beyond just answering technical questions. - Manage multiple client engagements simultaneously. - Lead engagements from start to finish and complete all aspects of attestation engagements including status updates to engagement managers and adhere to all quality control standards as required. - Review associates’ work and provide constructive review points. - Demonstrate the ability to recognize problems and propose sensible solutions, with an appropriate balance between client needs and the firm’s risk. - Show what you know! You have the knowledge—now apply it to real life situations. Thinking outside of the box is encouraged. - Support an innovative and team-oriented work environment. - Attend professional development and training sessions on a regular basis and apply what you learn to your assigned tasks. Qualifications - You have a Bachelor’s degree in Accounting with 150 credit hours or a Master’s degree. - You are a licensed CPA (preferred, not required). - You have at least 4 years of public accounting experience. - You are friendly and a team player. - You are highly organized and detail oriented. - You don’t blink twice at working under pressure with deadlines. - You take pride in your work. - You consider “follow through” the heart of client service. - Willingness to learn and desire for personal growth. - Professionalism - clock-punchers need not apply; we do what it takes to get the job done. - You enjoy a challenge and working with multiple types of clients and industries. Benefits - Competitive base salary (commensurate with experience). - Retirement plan. - Health/dental/vision insurance. - Self-managed PTO. - Continuing education. - Incentives for achieving designations/certificates that bring value to the firm. Company Description Big firm expertise with small firm customer service. With over 75 employees, MHP is the largest regional CPA firm in Wyoming. However, since our start in the early 1930s, MHP has been dedicated to personalized customer service to both our employees and clients. MHP is deeply rooted in the Cheyenne community, both figuratively and literally—not only have we been around for over 90 years, but our office is also located in the heart of downtown Cheyenne within walking distance of good food, coffee, and breweries. Tradition meets modernization. While the wild west may come to mind when you think of Wyoming, and that is a part of our history we hold dear, don’t think we’ve been left in the proverbial dust. Our city is home to topnotch restaurants, breweries, shopping, art galleries, and theater. Where you might see History and Today collide best may be Cheyenne Frontier Days, the largest and oldest rodeo in the world. Hundreds of thousands of people from all over come to Cheyenne to see the concerts, special events, and rodeo each year. If the outdoors are more your scene, Wyoming is not lacking there either. We have some of the best camping, skiing, fishing, hunting, climbing, and biking in the country. You’re more than a number. As part of our MHP team, you'll have the unique opportunity to make your mark on the company and advance your career in the area you desire. Managers and Partners have an “open door policy”, which is practically unheard of in larger firms. We encourage employees to get involved in our community as well as with each other—we host several team building and employee events every year, including holiday parties, BBQs, cornhole tournaments, Friday Nights on the Plaza (a Cheyenne summer concert series), and more! Be a part of something bigger. At MHP, we strive to not only be experts in our field but also provide superior client service to our wide variety of clientele. We are a team—always willing to give a helping hand to our coworkers when we’re able and will bend over backwards for our clients. We pride ourselves on servant leadership—we are leaders in our office and our community.