Audit Operations Lead

This is a fully remote position, open to applicants in Connecticut.

📋 Description

• Deliver expert support for intricate client, regulatory, accreditation, and internal audits.

• Oversee audit processes from initiation through execution, remediation, validation, and completion.

• Assist with CMS program and mock audits, delegation and data validation audits, NCQA and URAC audits, as well as internal audit findings and remediation, along with other compliance, regulatory, or operational initiatives.

• Define requirements, timelines, dependencies, and deliverables.

• Convert complex or incomplete requests into actionable next steps.

• Investigate unfamiliar issues and consult with subject matter experts as necessary.

• Coordinate activities among various teams and stakeholders.

• Organize audit preparation, meetings, requirement discussions, and follow-ups.

• Maintain documentation and convey status, risks, and next steps.

• Recognize and escalate risks while proposing solutions.

• Enhance SOPs, workflows, tools, and audit processes.

⛳️ Requirements

• High school diploma is mandatory; a bachelor’s degree is preferred.

• 5+ years of experience in client/customer support, healthcare operations, audit, compliance, project coordination, or a similar field.

• Proven experience in managing complex, time-sensitive tasks across multiple teams.

• Excellent communication, organizational, problem-solving, adaptability, and time-management abilities.

• Preference for experience in healthcare, regulatory, accreditation, client, or internal audits.

• Preference for experience in developing or enhancing SOPs, workflows, or process documentation.

• Familiarity with prior authorization, post-service processes, reporting, or relevant eviCore systems is preferred.

• If working remotely, must have cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload speeds.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical benefits.

• Vision benefits.

• Dental benefits.

• Well-being and behavioral health programs.

• 401(k) plan.

• Company-paid life insurance.

• Tuition reimbursement.

• A minimum of 18 days of paid time off each year.

• Paid holidays.

• Leaves of absence.