External Audit Manager

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

📋 Description

• Act as the main contact and internal facilitator for external audits, surveys, regulatory assessments, payer audits, and oversight inquiries.

• Organize audit schedules, logistics, document requests, evidence gathering, stakeholder follow-ups, and ensure submission readiness.

• Lead or assist in responding to federal, state, Medicaid, CMS, OIG, accrediting body, MCO, and payer audits.

• Analyze audit results, pinpoint risk areas, and draft responses to Statements of Deficiency, information requests, and related audit correspondence.

• Design, implement, and oversee corrective action plans that address root causes, accountability, timelines, evidence, and remediation efforts.

• Monitor CAP completion, validate effectiveness, and escalate overdue or high-risk remediation items.

• Perform root cause analyses and identify patterns, recurring issues, or control deficiencies that necessitate process improvements.

• Maintain the audit repository, evidence files, response trackers, CAP logs, and supporting documentation.

• Collaborate with Operations, Clinical, HR, Legal, Finance, IT, and Compliance stakeholders.

• Present audit status, findings, trends, risks, and remediation progress to Compliance leadership and business executives.

⛳️ Requirements

• A bachelor’s degree in healthcare administration, business administration, public health, legal studies, compliance, or a related field is required.

• At least eight years of experience in healthcare compliance, regulatory affairs, auditing, quality assurance, Medicaid, managed care, or home health/home care operations is required.

• Strongly preferred experience in managing external audits, survey responses, Medicaid/CMS or state agency reviews, SOD responses, CAP development, and corrective action tracking.

• Preferred certifications include CHC, CHPC, CCEP, or other similar compliance credentials.

• In-depth knowledge of Medicaid-funded home care regulations, healthcare compliance requirements, audit methodologies, survey processes, and documentation standards is essential.

• Capability to assess risk, investigate issues, identify root causes, and recommend practical corrective actions.

• Strong skills in document control, project management, and organization.

• Ability to handle multiple audits, deadlines, stakeholders, and evidence requests concurrently.

• Exceptional written and verbal communication skills.

• Strong analytical abilities including data interpretation, trend identification, monitoring remediation progress, and providing status updates.

• Sound judgment, discretion, and meticulous attention to detail with confidential and regulatory documentation.

• Comfortable operating in a fast-paced, remote setting with changing priorities.

• Ability to sit for prolonged periods and perform office-related tasks.

• Capacity to lift, push, pull, and carry up to 25 pounds.

• Ability to bend, twist, stoop, kneel, and reach.

• Willingness to travel up to 25% as necessary.

🏝️ Benefits

• Competitive compensation.

• Medical benefits.

• Retirement plans.

• Wellness programs.

• Enjoyable company events.

• Continuous learning opportunities to advance your career.

• Inclusive workplace environment.

• Equal Opportunity Employer.