Remote Healthcare Improvement Auditor

Jobgether; Central City (KY); Remote; USD 70,000 - 120,000; Full time

Benefits offered by this job

Remote flexibility

Medical coverage

401(k) contributions

PTO and holidays

Volunteer time off

Job summary

Jobgether is seeking a Delegate Improvement Auditor/Analyst in the United States to lead complex analytical initiatives for delegated healthcare oversight, regulatory compliance, and performance improvement. You will design metrics, audit delegated partners against standards, and support DHS/CMS audits while collaborating across clinical, operational, compliance, and analytics teams.

The role emphasizes data-driven decision-making, cross-functional collaboration, and continuous process

Qualifications

• Bachelor's degree in Nursing, Social Work, Healthcare Administration, or related field
• At least five years of professional work experience beyond the degree
• Strong analytical skills, including interpreting complex data and developing metrics
• Experience evaluating performance against standards and documenting findings
• Strong written and verbal communication skills
• Excellent organizational skills and attention to detail
• Ability to work independently and manage complex projects
• Strong collaboration and problem-solving skills
• Preferred: care coordination, government healthcare programs, Medicaid SNP, project/program management, MS Office

Responsibilities

• Develop performance metrics and analytical insights: Design and maintain metrics that evaluate delegated entity performance, quality outcomes, and regulatory compliance. Produce reports and analyses that translate complex data into clear, actionable recommendations.
• Identify trends and improvement opportunities: Analyze performance patterns, emerging risks, and operational gaps across delegated programs. Communicate findings to stakeholders to support informed decision-making and measurable improvements.
• Conduct audits and oversee delegate performance: Complete comprehensive audits based on applicable state and federal requirements. Evaluate performance against contractual obligations, regulatory standards, and quality expectations, documenting findings and recommended actions.
• Drive corrective actions and continuous improvement: Collaborate with internal teams and delegated partners to identify deficiencies, develop improvement strategies, monitor corrective actions, and validate sustained progress.
• Coordinate government audit support: Support preparation for Department of Human Services (DHS) and Centers for Medicare & Medicaid Services (CMS) audits, including data validation, report preparation, and documentation collection.
• Manage audit requests and follow-up: Work with delegates and internal stakeholders to provide accurate, timely, and well-supported responses to audit inquiries. Track findings, coordinate resolution activities, and support follow-up efforts.
• Strengthen cross-functional data integration: Partner with clinical, operational, compliance, and analytics teams to align information across reports, submissions, and oversight tools. Investigate discrepancies through root-cause analysis and help maintain data consistency.
• Provide analytical guidance: Serve as a resource for colleagues on performance metrics, reporting standards, analytical methods, and interpretation of results.
• Improve processes and analytical tools: Identify opportunities to enhance reporting workflows, oversight procedures, and analytical tools, recommending changes that improve accuracy, efficiency, and usability.
• Support broader oversight initiatives: Contribute advanced analytical judgment and strategic recommendations to strengthen delegate oversight, program performance, and organizational analytical capabilities.

Skills

Analytical skills

Communication skills

Organizational skills

Independent work

Collaboration

Data interpretation

Education

Bachelor's degree in Nursing, Social Work, Healthcare Administration, or related field

Equivalent relevant work experience

Tools

Excel

Word

PowerPoint

Job description

Jobgether is seeking a Delegate Improvement Auditor/Analyst in the United States to lead complex analytical initiatives for delegated healthcare oversight, regulatory compliance, and performance improvement. You will design metrics, audit delegated partners against standards, and support DHS/CMS audits while collaborating across clinical, operational, compliance, and analytics teams.

The role emphasizes data-driven decision-making, cross-functional collaboration, and continuous process