Remote Director, Integrated Care Audit & Compliance

CareSource; United States; À distance; USD 136 000 - 237 000; Plein temps

Avantages offerts par ce poste

Remote position

Competitive benefits

Résumé du poste

CareSource is seeking a Director, Integrated Care Audit Management to provide strategic leadership and oversight for regulatory audits, quality reviews, and compliance across Integrated Care products and markets.

In partnership with Compliance, IT, and Care Coordination, this role directs audit readiness, coordinates responses and universe submissions, evaluates findings, and ensures timely corrective actions while strengthening internal controls to align with CMS, Medicaid, Medicare, NCQA

Qualifications

• Bachelor's degree in business or related field.
• Master's degree preferred.
• Five years of healthcare operations, managed care, or audit management experience.
• Three years of CMS Program Audit experience.
• Three years of management experience in audit leadership.

Responsabilités

• Lead enterprise and regulatory audits for Integrated Care products across markets.
• Coordinate audit responses and universe submissions with Compliance.
• Strengthen internal controls and mitigate regulatory risk.
• Educate stakeholders on audit protocols and compliance.
• Present findings and recommendations to Care Coordination leadership.
• Ensure timely completion of corrective action plans.

Connaissances

Regulatory audits

Audit management

Project management

Risk assessment

Stakeholder communication

Regulatory knowledge

Formation

Bachelor's degree in business or related field

Master's degree in business or related field

Outils

Microsoft Word

Microsoft Excel

PowerPoint

Description du poste

CareSource is seeking a Director, Integrated Care Audit Management to provide strategic leadership and oversight for regulatory audits, quality reviews, and compliance across Integrated Care products and markets.

In partnership with Compliance, IT, and Care Coordination, this role directs audit readiness, coordinates responses and universe submissions, evaluates findings, and ensures timely corrective actions while strengthening internal controls to align with CMS, Medicaid, Medicare, NCQA