Analyst I - Adverse Action Adjudicator

Job Summary

Position Summary: Reviews the position requirements associated with each case, including minimum qualifications and required pre-employment verifications, together with candidate disclosures, consent forms, resumes, and background investigation results to determine whether requirements are met and information aligns. Applies the established adjudication matrix and renders objective, impartial decisions based on the facts presented. The Adverse Action Adjudicator must remain neutral and free of conflicts of interest while determining whether discrepancies, omissions, or unmet requirements are sufficient to disqualify a candidate from employment.

Responsibilities

Major Responsibilities

• Review the position requirements associated with each case, including minimum qualifications and required pre-employment verifications, and compare them with the candidate's consent form, resume, disclosures, and background investigation results to confirm alignment and completion.
• Evaluate discrepancies or omissions between information disclosed by the candidate and information verified through the background investigation, including whether nondisclosure affected the scope of screening, and apply the established adjudication matrix to determine the appropriate course of action.
• Consult with the background investigation vendor and/or the subject of the investigation, as needed, to clarify relevant facts and circumstances.
• Render approval or denial decisions in accordance with the adjudication matrix and, as applicable, relevant laws, regulations, policies, precedent, and informed assessment of potential risk to the employer.

Governance Compliance

• Periodically review the adjudication matrix used by Recruiting and recommend revisions as appropriate.
• Create and maintain complete records of adjudication decisions, including the rationale supporting each course of action.
• Develop and maintain adjudication analytics to support reporting and informed decision-making.
• Safeguard the confidentiality of all adjudication materials and related information.
• Recommend improvements to adjudication processes, products, and services.
• Exercise independent judgment and operate with minimal supervision in a complex environment.
• Conduct investigations and recommend resolutions in collaboration with Legal, Ethics and Compliance, Human Resources Business Partners, and other stakeholders as appropriate.
• Monitor emerging business challenges and regulatory developments that may affect adjudication practices.

Other

• Perform other duties as assigned.
• Adhere to HCA Healthcare's Code of Conduct, Mission, and Values.

Education Experience

• Bachelor's degree (required)
• Minimum of 1 year of relevant professional experience (required)

Must Have Skills

• Demonstrated ability to solve unique and complex problems with broad business impact
• Proficiency with computers and business software applications
• Strong proficiency in Microsoft Office, including Outlook, Word, and Excel
• Strong written communication skills

Knowledge, Skills, Abilities, Behaviors

Service and Quality Excellence

Demonstrates an unwavering commitment to delivering exceptional care and creating an unmatched value proposition for patients.

Required

Honor our Mission and Values

Builds trust and acts authentically to foster a culture of integrity, inclusion, and mutual respect.

Disclaimer: This job posting has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.