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Healthcare, Hospitals & Clinics, Health Insurance, Medical Research

Healthcare Operations Internal Auditor, Senior II

Pittsburgh, PAHybridFull TimeSeniorPosted 1 month agoVisa sponsorship available

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Required skills

  • healthcare operations
  • internal audit
  • clinical operations
  • regulatory audits
  • risk assessments
  • audit plan
  • enterprise risk management
  • process improvement
  • executive communication
  • project management

Nice to have

  • RN
  • LPN
  • CHC
  • CPC
  • CIA
  • Six Sigma

Role summary

The Senior II Healthcare Auditor leads operational, clinical, and regulatory audits within the health services division, providing strategic insight and subject matter expertise. This role is responsible for assisting other auditors, influencing enterprise risk management related to clinical operations, and evaluating enterprise-level clinical controls and governance structures. The auditor will use operational, clinical, and revenue cycle data in the audit process and present findings to senior leadership. A Bachelor's degree or equivalent clinical certification and 5+ years of progressive clinical, audit, or compliance experience are required.

Purpose:
The Senior II Healthcare Auditor leads operational audits within the health services division (HSD) and provides strategic insight to Internal Audit and Operational leadership. Leveraging healthcare operations expertise, the Expert Auditor is intended to infuse their subject matter knowledge throughout the audit process. This role is responsible for assisting other auditors and influencing enterprise risk management related to clinical operations.

Location: This position will be based out of the Steel Tower in Pittsburgh, PA. This position will have the potential to work from home on a hybrid schedule which includes some days in office and some days at home per week.

Responsibilities:
 

  • Lead operational, clinical, and regulatory audits 
  • Contribute to risk assessments and the annual audit plan 
  • Evaluate enterprise level clinical controls and governance structures 
  • Provide advisory support for new clinical initiatives, acquisitions, and regulatory changes 
  • Assist and train other auditors 
  • Coordinate with and assess Compliance, Legal, Quality, and Revenue Cycle (all second lines of defense functions) 
  • Present audit results to senior and executive leadership 
  • Identify systematic trends and surface emerging risks across multiple locations 
  • Use operational, clinical, and revenue cycle data and workflow design knowledge in the audit process


  • Bachelors degree or equivalent clinical certification 
  • 5+ years of progressive clinical, audit, or compliance experience 
  • OR High School Diploma/GED and seven years of related work experience. 
  • Demonstrated expertise in healthcare operations 
  • Strong executive communication and influence skills 
  • Superior computer skills, including experience in MS Office tools: Word, Excel, Outlook PowerPoint, CoPilot and SharePoint 
  • Strong understanding of risk analysis and process improvement. 
  • Willingness to travel, as needed

Key Competencies

  • Clinical and regulatory subject matter expertise

  • Audit planning, execution, and reporting leadership

  • Strong written and verbal communication

  • Risk assessment, process improvement, and root cause analysis

  • Excellent project management skills

  • Sound professional judgment and discretion

    Licensure, Certifications, and Clearances:
     RN, LPN, CHC, CPC, CIA, Six Sigma or CPMA preferred

     

  • Act 34


    UPMC is an Equal Opportunity Employer/Disability/Veteran

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