Senior UM Audit & Compliance Lead (Remote)

Integra Partners; Florida; On-site; USD 81,000 - 99,000; Full time

Benefits offered by this job

Competitive compensation

Annual bonus program

401(k) retirement program with company

Job summary

Integra Partners is seeking a Senior Utilization Management Audit & Compliance Analyst to lead external audits, respond to inquiries, and oversee UM compliance across Medicare, Medicaid, Commercial, and Dual Eligible populations. The role requires strong analytical and writing skills, with advanced Excel proficiency to analyze large data sets and validate findings.

The candidate will review authorization records in Essette, coordinate with internal teams, and ensure timely, accurate audit

Qualifications

• 5–10 years of experience in healthcare operations, UM, and/or audit support.
• Experience preparing reports and analyzing data with attention to accuracy.
• Excellent written and verbal communication skills.
• Ability to build cross-functional relationships across Operations, IT, and external clients.

Responsibilities

• Serve as primary lead for external customer audits and oversight reviews.
• Review audit findings, inquiries, and data validation requests from health plans and regulators.
• Conduct investigations to validate findings and determine root causes.
• Draft clear, professional responses to audit findings and develop corrective actions.
• Analyze UM data to support audits and business reviews.

Skills

Analytical skills

Written communication

Verbal communication

Organization

Education

Bachelor’s degree in healthcare administration, public health, or related field

Tools

Essette

Excel

Job description

Integra Partners is seeking a Senior Utilization Management Audit & Compliance Analyst to lead external audits, respond to inquiries, and oversee UM compliance across Medicare, Medicaid, Commercial, and Dual Eligible populations. The role requires strong analytical and writing skills, with advanced Excel proficiency to analyze large data sets and validate findings.

The candidate will review authorization records in Essette, coordinate with internal teams, and ensure timely, accurate audit