Remote Senior UM Audit & Compliance Analyst

Jobgether SRL; United States; Remote; USD 81,000 - 99,000; Full time

Job summary

Jobgether, a healthcare organization specializing in utilization management and regulatory compliance, seeks an experienced audit professional to support external audits and regulatory inquiries.

You will analyze UM data, prepare evidence-based responses for health plans and regulators, lead audit responses, and develop corrective action plans. Proficiency in Excel and strong communication are essential; remote work is available in the U.S.

Qualifications

• 5-10 years of healthcare operations or audit support experience.
• Knowledge of CMS, NCQA, and state regulatory UM requirements.
• Excellent written and verbal communication skills with attention to detail.

Responsibilities

• Serve as a subject matter expert for external customer audits and regulatory inquiries.
• Analyze utilization management data and prepare evidence-based responses for health plans, regulators, and accreditation organizations.
• Lead audit response activities and investigate UM records to validate findings.
• Develop corrective action plans and monitor implementation across teams.
• Use advanced Excel to analyze large datasets and create audit exhibits.

Skills

Communication skills

Attention to detail

Tools

Excel

Job description

Jobgether, a healthcare organization specializing in utilization management and regulatory compliance, seeks an experienced audit professional to support external audits and regulatory inquiries.

You will analyze UM data, prepare evidence-based responses for health plans and regulators, lead audit responses, and develop corrective action plans. Proficiency in Excel and strong communication are essential; remote work is available in the U.S.