Compliance Reviewer/Auditor

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $70k - $105k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

👻 Ghost score 0%

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StrategyGen Co. (SBA Certified HUBZone Small Business)

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2009

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

StrategyGen Co. is a HUBZone-certified small business that provides government-focused consulting and technical assistance to federal agencies, specializing in healthcare policy, program integrity, research and evaluation, quality improvement, and workforce development. The firm delivers regulatory support, program evaluation, data-driven policy analysis, training, and implementation services to agencies such as CMS, DoD, HHS, HUD, and SBA, helping clients improve outcomes, reduce costs, and enhance operational effectiveness.

📋 Description

• Conduct assigned QHP, Targeted, Expedited, and other Marketplace compliance review activities in accordance with approved review protocols, testing instructions, schedules, and procedures • Research and analyze applicable ACA requirements, CMS regulations, guidance, and issuer materials to support compliance testing and conclusions • Review issuer documentation and data, perform assigned testing and sampling, and document procedures, evidence, results, and conclusions clearly and traceably • Identify and document potential noncompliance and develop clear, fact-based findings supported by applicable requirements and sufficient evidence • Draft findings, report language, exhibits, workpapers, and other review documentation • Revise work products in response to technical, quality, and CMS review comments • Maintain complete and accurate review documentation in approved project repositories • Participate in reviewer calibration sessions, issuer kickoff meetings, interviews, exit conferences, and other review meetings as assigned • Support issuer document requests, interview preparation, work plans/corrective actions, and validation of remediation evidence, as applicable • Manage assigned review activities and milestones, provide timely status updates, and escalate schedule, evidence, quality, or technical issues to the designated review lead • Support updates to review protocols, testing instructions, templates, SOPs, and other compliance review tools • Contribute to lessons learned and process improvement activities • Work independently under minimal supervision while collaborating within an established review, quality, and leadership structure • Conduct independent research and deliver high-quality products on time

🎯 Requirements

• Bachelor’s degree plus at least four (4) years of relevant experience, or a Master’s degree plus at least two (2) years of relevant experience • Experience in healthcare compliance, health insurance regulation, regulatory review, auditing/examination, internal controls, program integrity, or a closely related field • Knowledge of the Affordable Care Act (ACA), Health insurance/Marketplace operations, and related federal healthcare regulations and guidance • Experience performing structured compliance reviews or audits, including evidence evaluation, testing, workpaper documentation, findings development, and written reporting • Strong analytical, research, critical-thinking, organizational, and time-management skills, with the ability to manage multiple priorities and meet established deadlines • Excellent written and verbal communication skills and demonstrated ability to produce clear, concise, factual, and technically accurate work products • Ability to work independently with limited supervision, collaborate effectively with a multidisciplinary team, and incorporate technical and quality-review feedback • Experience with TeamMate+, ACL or other comparable audit/workpaper management software is preferred • Relevant professional certifications or designations—such as CHC, CHPC, CIA, CFE, CHRC, or comparable healthcare/compliance/audit credentials—are preferred • Candidates must be able to participate reliably in virtual meetings and use project-approved systems and collaboration tools • Candidates must be currently located in the United States and able to perform this position remotely from within the United States • Legally authorized to work in the US

🏖️ Benefits

• 401(k) matching • Competitive salary • Dental insurance • Flexible schedule • Health insurance • Paid time off • Tuition assistance • Vision insurance • Limited travel or onsite participation may be required based on specific review needs • HUBZone-resident candidates may receive preference in the hiring process