Clinical Compliance Analyst - Audits & Quality Improvement

Senior LIFE; Greensburg (Westmoreland County); On-site; USD 65,000 - 85,000; Full time

Job summary

PACE Consulting Solutions seeks a Clinical Analyst for a full-time role in Greensburg, PA (also serving Johnstown, PA). The analyst will conduct medical record audits to ensure documentation accuracy and regulatory compliance, delivering real-time feedback to management and staff to meet standards.

The role requires auditing expertise, familiarity with Medicare/Medicaid regulations, and the ability to educate staff while supporting site visits and mock audits to improve care quality.

Qualifications

• RN license is 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 real-time auditing by program staff to ensure compliance.
• Schedule, facilitate and participate in mock audits to gauge readiness and identify improvements; provide mock audit reports and oversee remediation.

Skills

Regulatory oversight

Healthcare administration

Audit and quality improvement

Education

RN license preferred

Job description

PACE Consulting Solutions seeks a Clinical Analyst for a full-time role in Greensburg, PA (also serving Johnstown, PA). The analyst will conduct medical record audits to ensure documentation accuracy and regulatory compliance, delivering real-time feedback to management and staff to meet standards.

The role requires auditing expertise, familiarity with Medicare/Medicaid regulations, and the ability to educate staff while supporting site visits and mock audits to improve care quality.