Location: United States
Job Summary:
1. Job Duties and Scope:
- Develop and maintain the audit playbook for regulatory and mock audits across all lines of business.
- Manage changes in Utilization Management (UM) requirements due to contractual changes or All Plan Letter directives.
2. Required Skills:
- Strong understanding of clinical compliance regulations and audit processes.
- Proficiency in project management and regulatory analysis.
3. Required Experiences:
- Significant experience in clinical compliance management and audit methodologies.
- Previous work with UM requirements and regulatory frameworks is preferred.
Job URLs: