The posting
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Compliance Analyst based in United States.
This remote role offers the opportunity to strengthen compliance across a healthcare-focused organization and its provider network. You will play a key role in monitoring fraud, waste, and abuse (FWA), conducting audits, and investigating potential compliance concerns. Working closely with legal, compliance, credentialing, quality, security, and network teams, you will help identify risks and drive effective remediation. You will also support regulatory filings, compliance training, security risk assessments, and customer audits. The role combines analytical work, healthcare regulatory knowledge, and cross-functional collaboration. It is well suited to a proactive professional who enjoys interpreting complex information and turning findings into practical improvements.
Accountabilities
- Conduct audits of healthcare providers and vendors to support fraud, waste, and abuse monitoring and compliance programs.
- Lead or support FWA investigations, research providers and relevant regulatory alerts, and investigate internal and external compliance concerns.
- Support the administration and continuous improvement of the corporate compliance program, including assigning compliance training and maintaining complete, auditable records.
- Collaborate with credentialing, quality assurance, network management, security, and other cross-functional teams to address compliance concerns and implement corrective actions.
- Partner with health plan customers on business audits, including developing, documenting, tracking, and responding to audit requests.
- Monitor licensing requirements and state regulatory filings to help ensure ongoing compliance.
- Conduct security risk assessments, present findings to the compliance committee, and collaborate with security teams to resolve identified issues.
- Monitor regulatory and industry developments affecting healthcare and DMEPOS operations and recommend updates to processes, policies, and controls.
- Build strong working relationships with internal stakeholders and external partners while providing responsive, high-quality compliance support.
- Take ownership of assigned audits and projects, manage multiple priorities, and deliver accurate work within established deadlines.
- Bachelor’s degree required.
- At least 3 years of experience in Special Investigation Unit processes, healthcare compliance, fraud investigations, or a comparable role.
- Previous healthcare industry experience is required; experience with DMEPOS is strongly preferred.
- Strong knowledge of fraud, waste, and abuse, healthcare credentialing, medical billing, HIPAA, and related healthcare legislation and regulations.
- Working knowledge of medical billing processes and healthcare compliance practices.
- Strong analytical capabilities, including experience working with data and advanced proficiency in Microsoft Excel; Tableau experience is a plus.
- Excellent attention to detail and the ability to interpret complex information and communicate it clearly to technical and non-technical audiences.
- Strong written and verbal communication skills, with the ability to work effectively with clients, executives, and cross-functional stakeholders.
- Excellent organizational and project management skills, with the ability to manage multiple priorities, meet tight deadlines, and follow assignments through to completion.
- High standards of integrity, ethics, discretion, and professional judgment when handling sensitive and confidential information.
- A service-oriented mindset and the ability to build trusted-advisor relationships with key stakeholders.
- Collaborative approach and demonstrated ability to work effectively across teams and organizational levels.
- Self-starter who is comfortable working independently while remaining proactive in communication and escalation.
- Annual salary of $85,000.
- Competitive compensation and annual bonus program.
- Remote work opportunities across eligible U.S. locations.
- 401(k) retirement plan with company match.
- Company-paid life insurance.
- Company-paid short-term disability coverage, subject to location restrictions.
- Medical, dental, and vision benefits.
- Paid time off, sick time, company holidays, and floating holidays.
- Paid parental leave.
- Quarterly company-sponsored events.
- Health and wellness programs.
- Career development and professional growth opportunities.
- Inclusive, collaborative work environment with opportunities to partner across healthcare, compliance, legal, security, and operational functions.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
#LI-CL1
