Senior UM Audit & Compliance Strategist

Integra Partners; United States; Remote; USD 81,000 - 99,000; Full time

Benefits offered by this job

Bonus program

401(k) match

Life insurance

Disability coverage

Medical, Vision, Dental

PTO

Parental leave

Sick time

Holidays & floating holidays

Wellness programs

Career development

Job summary

Integra Partners is seeking a Senior Utilization Management Audit & Compliance Analyst to serve as the SME for external audits, regulatory inquiries, and UM oversight. You will review audit requests, analyze UM data in Essette, and prepare evidence-based responses for health plans, regulators, and clients.

The ideal candidate has extensive UM experience across Medicare, Medicaid, Commercial and Dual Eligible populations, plus strong regulatory knowledge, writing and Excel skills, and the ability

Qualifications

• 5–10 years of experience in healthcare operations, UM, and/or audit support.
• Strong organizational skills with multiple deadlines.
• Experience preparing reports and analyzing data.
• Excellent written and verbal communication, with attention to detail.

Responsibilities

• Serve as the primary lead for external audits and oversight reviews.
• Review audit findings, inquiries, and data validation requests.
• Investigate to validate findings and determine root causes.
• Draft professional responses and develop corrective action plans.
• Ensure timely and accurate audit responses.
• Support audit readiness and stakeholder meetings.
• Identify process improvements from recurring issues.

Skills

Audit management

Data analysis

Excel proficiency

Regulatory knowledge

Communication skills

Process improvement

Education

Bachelor’s degree in healthcare administration

Tools

Essette UM system

Pivot Tables

VLOOKUP/XLOOKUP

Data visualization

Job description

Integra Partners is seeking a Senior Utilization Management Audit & Compliance Analyst to serve as the SME for external audits, regulatory inquiries, and UM oversight. You will review audit requests, analyze UM data in Essette, and prepare evidence-based responses for health plans, regulators, and clients.

The ideal candidate has extensive UM experience across Medicare, Medicaid, Commercial and Dual Eligible populations, plus strong regulatory knowledge, writing and Excel skills, and the ability