Clinical Compliance and Operations Auditor
$95,000–$110,000 year
On-site · Dearborn, Michigan, United States
Job Summary
Clinical Compliance and Operations Auditor conducts unannounced onsite reviews of centers within an assigned territory, performs center walk-throughs, interviews staff, reviews client records for regulatory and payor compliance, and prepares staff to respond to external evaluators. The role emphasizes data-driven reporting, real-time tracking of audit progress, and leadership briefings on findings, with travel up to 80% and requirements to adhere to HIPAA and BACB Ethics Code while ensuring high standards of clinical and operational integrity across a national provider network.
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
- Knowledge of ABA clinical and documentation best practices and terminology
- Experience with clinical review or payor clinical review responses
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