Senior Audit Manager – Nurse Investigations (Remote)

Jobgether

United States

Remote

USD 100,000 - 110,000

Full time

9 days ago

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Benefits offered by this job

Health insurance

Paid holidays

Paid vacation

Paid sick leave

Parental leave

Retirement plan

Professional development

Job summary

Jobgether is seeking an Audit Manager to lead the nurse investigations function with a focus on high-quality clinical reviews and consistent standards. You will manage the QA Nurse Investigations Unit, ensure regulatory compliance, and guide complex medical investigations while partnering with key stakeholders.

The role requires strong leadership, investigative know-how, and ability to document findings for defensible outcomes.

Qualifications

Active RN license with state requirements.
Strong knowledge of clinical record reviews and healthcare data analysis.
Experience with investigative/audit processes and defensible case development.

Responsibilities

Lead the Nurse Investigations Unit, overseeing recruitment, staff development, supervision and performance management.
Ensure compliance with Office of Inspector General standards and Arizona laws.
Apply clinical expertise to guide complex investigations and ensure regulatory compliance.
Coordinate with internal stakeholders and respond to external audits and inquiries.
Develop strategic plans, goals, and operational objectives for the unit.
Review investigation reports, case closures, and assessments for completeness.
Conduct complex clinical, financial, and data analyses and document findings.
Mentor staff and promote a high-performing, continuously improving team.
Interpret regulations to support investigative decisions and defend outcomes.