Clinical Compliance and Operations Auditor
$95,000–$110,000 year
On-site · Phoenix, Arizona, United States
Job Summary
Conduct unannounced onsite audits of centers within an assigned territory to observe live operations, perform center walk-throughs for safety and compliance, interview staff, and review client records to ensure regulatory and payor compliance. Prepare centers to respond to external evaluators (payors and accreditation bodies) with data-driven feedback; generate detailed audit reports; track findings; analyze travel time, reporting, and debriefing impact; monitor adherence to clinical quality elements of corrective action plans; lead and coordinate SMEs to address issues; ensure consistency in care and compliance across regions; travel up to 80% of the time; strong written/verbal communication to debrief staff and write reports.
Required Qualifications
- Master’s degree required
- BCBA certification
- BCBA-D preferred
- Minimum of 10 years of experience as a BCBA or higher
- Minimum of 3 years of experience in a senior leadership role overseeing clinical compliance for a large-scale, multi-state healthcare organization
- Proven track record navigating Medicaid, OIG, and private payor clinical audits
- Deep mastery of the BACB Ethics Code for Behavior Analysts and HIPAA privacy regulations
- Proven record of success in a highly detail-oriented, evaluative environment, experience in compliance or operational auditing preferred
Desired Qualifications
- BCBA certification
- BCBA-D preferred
- 10+ years of experience as a BCBA or higher
- 3+ years in a senior leadership role overseeing clinical compliance for a large-scale multi-state healthcare organization
- experience navigating Medicaid, OIG, and private payor clinical audits
- knowledge of ABA clinical and documentation best practices and terminology
- HIPAA privacy regulations
- ability to travel up to 80% of the time
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