Healthcare Compliance Auditor: Risk & Audit Leader

Provider Network Solutions, LLC; Miami (FL); Sur place; USD 65 000 - 90 000; Plein temps

Résumé du poste

Provider Network Solutions, LLC is seeking a Compliance Auditor to review business practices for regulatory adherence across the organization and delegated entities. This role includes recommending improvements, coordinating corrective actions, and ensuring effective change implementation through audit outcomes.

The ideal candidate will monitor evolving healthcare regulations, conduct internal and external audits, and support a robust Compliance Program with strong ethics and communication

Qualifications

• 3-5 years' experience in operational audits, regulatory compliance or government regulations.
• Knowledge in Healthcare industry preferred.
• Medicare, Medicaid, and Commercial Regulations knowledge.
• Compliance Certification is strongly desired.

Responsabilités

• Promote a strong code of ethics and integrity.
• Stay abreast of changes in healthcare laws, regulations and standards, including Medicare, Medicaid and Commercial regulations.
• Assist in risk/issue identification and remediation within external and delegation oversight audits.
• Resolve compliance issues identified through audits or monitoring with department leaders to ensure prompt response.
• Monitor and maintain quality of audited processes across departments.
• Analyze, organize and document audit findings and implement corrective actions.
• Conduct internal audits, develop quality indicators and present results to the Compliance Officer.
• Oversee external audits, ensuring timely completion and proper data submission.
• Maintain organized audit records and CAPs evidence.
• Adhere to policies to ensure compliance with the Compliance Program.

Connaissances

Presentation skills

Communication skills

Analytical skills

Problem solving

Time management

Attention to detail

AI knowledge

Formation

Bachelor's degree

Outils

Microsoft Office

Description du poste

Provider Network Solutions, LLC is seeking a Compliance Auditor to review business practices for regulatory adherence across the organization and delegated entities. This role includes recommending improvements, coordinating corrective actions, and ensuring effective change implementation through audit outcomes.

The ideal candidate will monitor evolving healthcare regulations, conduct internal and external audits, and support a robust Compliance Program with strong ethics and communication