Clinical Compliance Analyst - Audit & Quality

Senior LIFE PA; Johnstown (Cambria County); Hybrid; USD 65,000 - 90,000; Full time

Job summary

PACE Consulting Solutions is seeking a Clinical Analyst for a full-time role in Greensburg and Johnstown, PA. The analyst will perform medical record audits, ensuring documentation is complete, compliant, and accurate, while advising staff and providers to meet regulatory requirements.

The role requires experience in healthcare management and regulatory oversight, with on-site responsibilities and ongoing quality improvement initiatives to support Senior LIFE program operations.

Qualifications

• RN license preferred.
• Minimum of 3 years experience in health care management and regulatory oversight.
• Valid PA driver's license.

Responsibilities

• Review documentation to assure compliance with Medicare, Medicaid, and federal regulations.
• Identify areas of improvement, write plans of correction, and provide staff education.
• Provide on-site support during regulatory audits.
• Build trusting relationships with Senior LIFE program staff through open communication and education.
• Monitor development and implementation of quality initiatives with measurable goals and data-driven outcomes.
• Provide site visits including real-time auditing of center activities and member care.
• Oversee mock audits and remediation processes to gauge readiness and drive improvements.

Skills

Regulatory compliance

Healthcare management

Audit support

Education

RN license (preferred)

Job description

PACE Consulting Solutions is seeking a Clinical Analyst for a full-time role in Greensburg and Johnstown, PA. The analyst will perform medical record audits, ensuring documentation is complete, compliant, and accurate, while advising staff and providers to meet regulatory requirements.

The role requires experience in healthcare management and regulatory oversight, with on-site responsibilities and ongoing quality improvement initiatives to support Senior LIFE program operations.