Clinical Compliance and Operations Auditor
$95,000–$110,000 year
On-site · Atlanta, Georgia, United States
Job Summary
Clinical Compliance and Operations Auditor conducts unannounced onsite audits of centers within an assigned territory, performs comprehensive center walk-throughs to ensure regulatory and safety standards, interviews clinical and operational staff, reviews client records and clinical documentation for payor and regulatory compliance, and prepares staff for external evaluations by payors and accreditation bodies. Responsible for reporting and data analysis, generating detailed audit reports, tracking progress, and providing data-driven insights to leadership. Requires ability to travel up to 80% and to collaborate with leadership to improve operational and clinical quality across a national, high-volume 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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