Director, Audits (Healthcare)

📋 Description

• Lead healthcare audit operations: Provide strategic and operational leadership for Performance
• Oversee project delivery: Direct project planning, implementation, monitoring, and reporting across
• Manage and develop teams: Lead, mentor, and coach auditors and multidisciplinary analytical teams.
• Maintain quality and compliance: Ensure all client deliverables undergo appropriate internal review
• Build client and stakeholder relationships: Serve as a primary liaison with state Medicaid agencies
• Manage financial performance: Oversee staffing plans, labor utilization, project budgets, cost

🎯 Requirements

• A bachelor's degree or equivalent professional experience in Medicaid managed care, HEDIS
• At least 15 years of professional experience, including a minimum of 10 years in healthcare
• Certification as an NCQA Certified HEDIS Compliance Auditor (CHCA) or demonstrated proficiency in
• Extensive knowledge of Medicaid programs, managed care operations, health plan performance
• Demonstrated experience evaluating medical and prescription drug claims and encounter data
• Proven leadership experience managing multiple large-scale projects and supervising

🎁 Benefits

• Competitive annual salary: A base salary range of $133,000 to $160,000, depending on
• Fully remote work: The flexibility to work remotely within the United States.
• Work-life balance: Flexible work schedules designed to support personal well-being and professional
• Generous paid time off: Three weeks of paid time off annually, plus 13 company-paid holidays.
• Comprehensive healthcare coverage: Medical, dental, and vision insurance options.
• Retirement and ownership opportunities: Access to a 401(k) retirement savings plan and an employee