Audit Manager - Healthcare Industry

Summary:

The Healthcare Audit Manager is responsible for planning, executing, and overseeing audits within healthcare operations, ensuring compliance with regulatory standards, internal policies, and industry best practices. This role requires strong analytical skills, healthcare domain knowledge, and the ability to lead audit teams while collaborating with cross-functional stakeholders.

Responsibilities:

• Audit Planning & Execution
• Develop and implement annual audit plans for healthcare operations, billing, claims, and compliance.
• Conduct risk assessments to identify key focus areas.
• Lead audits across clinical, financial, and operational processes.
• Compliance & Risk Management
• Ensure adherence to healthcare regulations (HIPAA, Medicare/Medicaid, JCAHO, etc.).
• Identify gaps in compliance and recommend corrective actions.
• Monitor emerging regulatory changes and assess organizational impact.
• Reporting & Communication
• Prepare detailed audit reports with findings, risks, and recommendations.
• Track remediation efforts and follow-up audits.
• Team Leadership
• Supervise and mentor audit staff.
• Provide training on healthcare compliance and audit methodologies.
• Foster a culture of integrity and accountability.
• Process Improvement
• Recommend enhancements to internal controls and operational efficiency.
• Collaborate with departments to implement best practices.
• Support continuous improvement initiatives in healthcare delivery and administration.

Skills:

• Analytical thinking and problem-solving.
• Attention to detail and accuracy.
• Ethical judgment and integrity.
• Ability to manage multiple priorities under tight deadlines.
• Strong interpersonal and cross-cultural collaboration skills.

Education / Professional Experience/ Qualifications:

• Professional certifications such as CPA and CA are highly desirable.
• 7+ years of audit experience, with at least 3 years in healthcare audit or compliance.
• Strong knowledge of healthcare regulations and risk management frameworks.
• Excellent communication, leadership, and stakeholder management skills.
• Proficiency in audit tools, data analytics, and healthcare information systems.