Compliance Reviewer/Auditor

🕒 September 1

🇺🇸 United States – Remote

💵 $70k - $105k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

👻 Ghost score 8%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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