Director, Integrated Care Audit Management

CareSource

. Provide strategic leadership and operational oversight for internal and external regulatory audits, quality reviews, and compliance activities across Integrated Care products, markets, and businesses .

Posted 10/8/2026full-timeRemote • United StatesLead💰 $135,600 - $237,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in regulatory compliance, audit management, and healthcare operations, with a strong focus on strategic leadership and project management. Proficient in coordinating audits, managing corrective actions, and ensuring adherence to compliance standards across Integrated Care products and services.

Highest-signal resume keywords

Healthcare Operations ManagementCMS Program Audit ExperienceRegulatory Compliance ExpertiseProject Management SkillsStrategic Leadership

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Audit ManagementRegulatory ComplianceCorrective Action PlansAudit ReadinessQuality ReviewsData AnalysisRisk MitigationInternal ControlsMedicaid AuditsMedicare Audits

Soft Skills

Strong Communication SkillsAttention to DetailCritical ThinkingDecision-MakingTime Management

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPoint

Certifications & Qualifications

CHACHPCCHCACPHQ

Industry Keywords

Integrated CareManaged CareCompliance AuditsNCQA RequirementsGovernment Programs

About the role

Key responsibilities & impact

Provide strategic leadership and operational oversight for internal and external regulatory audits, quality reviews, and compliance activities across Integrated Care products, markets, and businesses
Collaborate with enterprise Compliance, IT, and Care Coordination leaders on audits and compliance activities
Direct audit readiness, regulatory responses, universe submissions, audit findings, corrective action plans, and required deliverables
Coordinate and direct responses and follow-up to audit findings and draft audit reports
Monitor action plans and ensure timely submissions
Support and facilitate Medicaid and Medicare audits
Perform or coordinate audits to determine compliance and ensure corrective actions
Educate Integrated Care management and teams on risk mitigation, internal controls, and regulatory compliance
Partner with business and IT teams on universe creation and review and approve universe submissions
Support education on audit protocols across markets
Identify care coordination auditing requirements and manage resources needed for compliance
Ensure internal audit tools meet contractual, regulatory, and NCQA requirements
Present audit results and process improvement recommendations to Care Coordination leadership monthly
Provide quarterly status reports to Integrated Care Executive Leadership
Support NCQA LTSS Distinction reporting and periodic survey facilitation
Maintain strategic relationships with internal and external stakeholders
Perform other job-related duties as requested

Requirements

What you’ll need

Bachelor's degree in business or related field required, or equivalent years of relevant work experience may be accepted in lieu of required education
Five (5) years of healthcare operations, managed care, or audit management experience required
Three (3) years of CMS Program Audit experience required
Three (3) years of previous management experience required
Understanding of Compliance, Regulatory and Audit fundamentals related to managed care and government programs audits (CMS/HHS/DOI/Medicaid/Marketplace and Medicare)
Exceptional project management skills and ability to lead complex audits and organizational initiatives in a matrixed environment
Strategic management and leadership skills, including decision-making and time management for audit facilitation and compliance adherence
Intermediate-level proficiency in Microsoft Word, Excel, and PowerPoint
Ability to work independently and within a matrixed environment
Attention to detail and strong communication skills
Critical listening and thinking skills
CHA, CHPC, CHCA, CPHQ or similar certification preferred
May be required to work additional hours and/or outside normal business hours as needed to meet deadlines

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Substantial and comprehensive total rewards package
Remote work
Travel is not typically required