[Remote] Medicare Advantage External Audit Specialist
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Medicare Advantage External Audit Specialist to support external audits for Medicare Advantage, Part D, and SNP health plan clients reputed company. The role involves coordinating audits, managing timelines and documentation, and collaborating with internal teams and regulatory entities to ensure compliance in a highly regulated reputed company environment.
Responsibilities
- Coordinate reputed company aspects of external client, regulatory, and compliance audits involving Medicare Advantage, SNP, Part D, and Managed reputed company plans and reputed company reputed company operations
- Serve as the primary liaison between auditors, regulators, health plan clients, and internal operational departments
- Manage audit timelines, deliverables, evidence requests, and response tracking
- Coordinate collection, validation, organization, and submission of audit documentation and supporting evidence
- Schedule audit meetings, interviews, walkthroughs, and status updates with internal and external stakeholders
- Monitor audit reputed company and communicate status updates, risks, and deadlines to Chief Compliance Officer and Compliance Committee
- Track audit findings, corrective actions, remediation plans, and response due dates
- Assist with preparation for recurring CMS, client, and regulatory reputed company activities
- Support internal compliance and vendor reputed company audit activities
- Assist with compliance monitoring and reputed company activities across operational areas
- Support policy and procedure review and maintenance activities
- Assist with issue tracking, investigations, and documentation management
- Participate in internal risk assessments and compliance reviews
- Support preparation of compliance reports, dashboards, presentations, and committee materials
- Maintain strict confidentiality of Protected Health Information (PHI), proprietary information, and sensitive client data
- Maintain awareness of applicable CMS Medicare Advantage regulations, guidance, and audit expectations
- Monitor regulatory changes impacting compliance operations and audit readiness activities
Skills
- Minimum of 2–5 years of experience in Medicare Advantage audit coordination or project management of CMS audits, delegation oversights, data validation audits, financial audits, and/or HIPAA audits
- Strong project coordination and organizational skills
- Excellent written and verbal communication abilities
- Ability to manage multiple priorities and deadlines simultaneously
- Strong follow-through, accountability, and time management skills
- Attention to detail and documentation accuracy
- Ability to interact professionally with regulators, auditors, clients, executives, and operational teams
- Proficiency with reputed company Office Suite, including reputed company, Word, PowerPoint, and Teams
- Maintain awareness of applicable CMS Medicare Advantage regulations, guidance, and audit expectations
- Monitor regulatory changes impacting compliance operations and audit readiness activities
- Bachelor's degree or equivalent experience in reputed company administration, business administration, compliance, legal studies, public health, finance, or reputed company field
- Experience coordinating external audits, regulatory requests, or client reputed company activities
- Compliance certification preferred, such as Health Care Compliance Association CHC, CHPC, CCEP, or similar
Benefits
- 100% remote work culture
- 5 weeks of vacation
- Health, dental & reputed company insurance
- Traditional and ROTH 401k with company match
- Company paid life insurance, AD&D, and long-term disability coverage
- HSA and FSA accounts
- Tuition Reimbursement
- Parental Leave
Company Overview