Remote Senior UM Audit & Compliance Analyst

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

Benefits offered by this job

401(k) retirement program

Company-paid life insurance

PTO

Remote work opportunity

Annual bonus program

Health and wellness programs

Job summary

Jobgether SRL is seeking a Senior Utilization Management Audit & Compliance Analyst for a fully remote role in the United States. You will lead external audit responses, analyze UM data, and ensure regulatory adherence across Medicare, Medicaid, Commercial, and Dual Eligible populations.

The ideal candidate combines UM expertise with advanced data analysis and strong writing skills, supporting audit readiness and process improvements across cross-functional teams.

Qualifications

• 5–10 years of experience in healthcare operations, utilization management, and/or audit support.
• Extensive experience with UM across Medicare, Medicaid, Commercial, and Dual Eligible populations.
• Strong understanding of UM regulations, accreditation standards, and delegation requirements.
• Experience reviewing audit findings, identifying root causes, and preparing formal responses.
• Strong data analysis and reporting experience with large datasets.

Responsibilities

• Lead audit response activities for external customer audits and UM oversight reviews.
• Review audit findings, regulatory inquiries, corrective action requests, and data validation requests.
• Conduct detailed investigations to validate findings and determine corrective actions.
• Prepare clear, evidence-based written responses to audit findings.
• Develop corrective action plans and monitor their implementation.
• Participate in mock audits and readiness reviews.

Skills

Audit & regulatory knowledge

Data analysis

Excel proficiency

UM experience

Cross-functional collaboration

Written communication

Education

Bachelor's degree in Healthcare Administration or related field

Tools

Essette

Job description

Jobgether SRL is seeking a Senior Utilization Management Audit & Compliance Analyst for a fully remote role in the United States. You will lead external audit responses, analyze UM data, and ensure regulatory adherence across Medicare, Medicaid, Commercial, and Dual Eligible populations.

The ideal candidate combines UM expertise with advanced data analysis and strong writing skills, supporting audit readiness and process improvements across cross-functional teams.