Senior Utilization Management Audit & Compliance Analyst (Fully Remote)

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. Key Responsibilities: 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. Requirements: 5-10 years of healthcare operations, utilization management, or audit support experience. Strong knowledge of CMS, NCQA, and state regulatory UM requirements. Excellent written and verbal communication skills with attention to detail. Annual salary of $90,000 plus competitive bonus and 401(k) match. Remote work available in select U.S. states with company-paid benefits and PTO. Jobgether This company is a healthcare organization specializing in utilization management and regulatory compliance. It operates with a remote team across the United States, fostering a collaborative and improvement-driven culture. #J-18808-Ljbffr