Senior Compliance Analyst

Job Summary

To support compliance excellence in a dynamic environment, the full-time remote Senior Compliance Analyst will lead utilization management audits, interpret CMS regulations, and collaborate with cross-functional teams to ensure adherence to regulatory standards.

Key responsibilities

• Lead and manage UM audits, identifying risks and driving corrective action plans
• Interpret and operationalize CMS Medicare/Medicaid guidelines while staying ahead of regulatory changes
• Present audit findings and compliance insights to leadership and support compliance training initiatives

Required qualifications

• Bachelor's degree or equivalent experience
• 4+ years in utilization management or healthcare compliance
• Deep knowledge of CMS Medicare/Medicaid regulations
• Experience with audits and corrective action plans (CAPs)