Healthcare Operations Internal Auditor, Senior II

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 100,000 - 135,000; Full time

Job summary

UPMC in Pittsburgh, PA, seeks a Senior II Healthcare Auditor to lead operational, clinical, and regulatory audits within the Health Services Division. The role provides strategic insight to Internal Audit and leadership, and supports enterprise risk management for clinical operations.

Hybrid schedule available with some days in the Steel Tower and some remote work. Responsibilities include risk assessment contribution, governance evaluation, advisory support for new clinical initiatives and

Qualifications

• Bachelors degree or equivalent clinical certification.
• Five plus years of progressive clinical, audit, or compliance experience.
• Demonstrated expertise in healthcare operations.
• Strong executive communication and influence skills.
• Superior computer skills including MS Office tools.
• Willingness to travel, as needed.

Responsibilities

• Lead operational, clinical, and regulatory audits.
• Contribute to risk assessments and the annual audit plan.
• Evaluate enterprise level clinical controls and governance structures.
• Provide advisory support for new clinical initiatives, acquisitions, and regulatory changes.
• Assist and train other auditors.
• Coordinate with Compliance, Legal, Quality, and Revenue Cycle (second lines of defense).
• Present audit results to senior and executive leadership.
• Identify systematic trends and surface emerging risks across multiple locations.
• Use operational, clinical, and revenue cycle data in the audit process.

Skills

Clinical operations expertise

Audit planning

Executive communication

Risk assessment

Process improvement

Project management

Discretion and judgment

Education

Bachelor's degree or clinical certification

High School Diploma/GED + 7 years experience

Tools

MS Office (Word, Excel, Outlook, PowerPoint)

SharePoint

CoPilot

Job description

The Senior II Healthcare Auditor leads operational audits within the health services division (HSD) and provides strategic insight to Internal Audit and Operational leadership. Leveraging healthcare operations expertise, the Expert Auditor is intended to infuse their subject matter knowledge throughout the audit process. This role is responsible for assisting other auditors and influencing enterprise risk management related to clinical operations.

The Senior II Healthcare Auditor leads operational audits within the health services division (HSD) and provides strategic insight to Internal Audit and Operational leadership. Leveraging healthcare operations expertise, the Expert Auditor is intended to infuse their subject matter knowledge throughout the audit process. This role is responsible for assisting other auditors and influencing enterprise risk management related to clinical operations. Location: This position will be based out of the Steel Tower in Pittsburgh, PA. This position will have the potential to work from home on a hybrid schedule which includes some days in office and some days at home per week.

• Lead operational, clinical, and regulatory audits
• Contribute to risk assessments and the annual audit plan
• Evaluate enterprise level clinical controls and governance structures
• Provide advisory support for new clinical initiatives, acquisitions, and regulatory changes
• Assist and train other auditors
• Coordinate with and assess Compliance, Legal, Quality, and Revenue Cycle (all second lines of defense functions)
• Present audit results to senior and executive leadership
• Identify systematic trends and surface emerging risks across multiple locations
• Use operational, clinical, and revenue cycle data and workflow design knowledge in the audit process
• Bachelors degree or equivalent clinical certification
• 5+ years of progressive clinical, audit, or compliance experience
• OR High School Diploma/GED and seven years of related work experience.
• Demonstrated expertise in healthcare operations
• Strong executive communication and influence skills
• Superior computer skills, including experience in MS Office tools: Word, Excel, Outlook PowerPoint, CoPilot and SharePoint
• Strong understanding of risk analysis and process improvement.
• Willingness to travel, as needed

Key Competencies

• Clinical and regulatory subject matter expertise
• Audit planning, execution, and reporting leadership
• Strong written and verbal communication
• Risk assessment, process improvement, and root cause analysis
• Excellent project management skills
• Sound professional judgment and discretion

Licensure, Certifications, and Clearances:

RN, LPN, CHC, CPC, CIA, Six Sigma or CPMA preferred

• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran