Provider Network Auditor - Compliance & Quality

Saginaw County Community Mental Health Authority; Saginaw (MI); On-site; USD 63,000 - 77,000; Full time

Job summary

Saginaw County Community Mental Health Authority seeks a Provider Network Auditor to conduct program audits, verify documentation, and ensure compliance with regulatory standards. You will work with the audit team to identify deficiencies and drive corrective action across contracted and board-operated programs.

The role requires a bachelor's degree in a related field, five years of healthcare or financial experience, and strong writing/presentation skills.

Qualifications

• Bachelor’s degree in social work, psychology, or related field with knowledge of health care administration or a business-related degree.
• Minimum five years of experience in health care, business or related financial or program field.
• Audit, data analysis, and knowledge of mental health systems helpful.
• Demonstrated writing and presentation skills.

Responsibilities

• Establish audit samples, bases, schedules and plans with team.
• Conduct annual, routine or ad-hoc audits and provider reviews.
• Identify deficiencies and recommend corrective actions.
• Present audit findings to providers with explanations and justifications.
• Verify service event documentation for approved funds and billing codes.
• Prepare audit summaries and reports for management.

Skills

Analytical ability

Finance/mathematics

Organization

Written communication

Verbal communication

Computer skills

Conflict management

Education

Bachelor’s degree in social work, psychology, or related

Job description

Saginaw County Community Mental Health Authority seeks a Provider Network Auditor to conduct program audits, verify documentation, and ensure compliance with regulatory standards. You will work with the audit team to identify deficiencies and drive corrective action across contracted and board-operated programs.

The role requires a bachelor's degree in a related field, five years of healthcare or financial experience, and strong writing/presentation skills.