Senior Utilization Management Audit & Compliance Analyst

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Utilization Management Audit & Compliance Analyst based in the United States.

This role serves as a subject matter expert for external customer audits, regulatory inquiries, and utilization management oversight activities. You will analyze complex UM data, investigate findings, and prepare accurate, evidence-based responses for health plans, clients, regulators, and accreditation organizations.

The position combines healthcare operations expertise with advanced data analysis, compliance knowledge, and detailed system review. You will work across Medicare, Medicaid, Commercial, and Dual Eligible populations while supporting audit readiness and regulatory adherence. The role also provides opportunities to identify recurring issues, recommend corrective actions, and improve operational processes.

This is a fully remote opportunity available in select U.S. states, with a strong focus on collaboration across operational, technical, and client-facing teams.