Manager UM Compliance

Job Summary

A company is looking for a Manager UM Compliance and Audit.

Key Responsibilities

• Oversee the UM Compliance & Audit program end to end
• Lead the annual UM compliance risk assessment and maintain the risk register
• Manage internal, client, and external UM audits, including corrective action plan development

Required Qualifications

• Bachelor's Degree in Healthcare Administration, Compliance, or related field
• Minimum 6 years of UM compliance and leadership experience in dental or medical insurance
• At least 3 years of hands-on experience with UM audits and compliance programs
• Strong knowledge of Medicaid Managed Care and Medicare Advantage UM requirements
• Experience working with NCQA, CMS, and URAC standards and readiness reviews