Regulatory Compliance Administrator Hybrid​/Remote

Regulatory Compliance Administrator (Hybrid/Remote)

The Regulatory Compliance Administrator collaborates with providers, managers, and staff to assist departments, clinics, and service lines in implementing, coordinating, and monitoring compliance practices. The incumbent is responsible for conducting medical necessity audits, performing regulatory and payment integrity audits, developing and standardizing policies and procedures, training and education, compliance investigations, and reporting to ensure compliance with University, State, and Federal guidelines.

• Maintain current knowledge of federal and state guidance and regulations.
• Prioritize audit requests based on risk, timelines, and available personnel.
• Review documentation for medical necessity using industry standard tools such as Inter Qual or Milliman.
• Assist providers and staff to implement compliance practices and monitor activities.
• Develop, monitor, and update quality controls and recommend actions to maintain compliance.
• Oversee, coordinate, and conduct audits and investigations to ensure compliance with guidelines.
• Analyze and document compliance processes and recommend enhancements.
• Design and implement training and education programs to enhance awareness.
• Serve as an expert resource in compliance issue resolution.

• Current licensure as a Physician’s Assistant in Utah with minimum three years of patient care experience OR current licensure as a Registered Nurse (BSN or APRN) in Utah with minimum five years of patient care experience.
• Proficiency with word processing, spreadsheet, and related computer applications.
• Exemplary human relations, effective communication skills, and sound knowledge of clinical practice.
• Exceptional critical thinking, leadership abilities, and coding certification (CPC, ACS, CCS‑P/H, RHIA, or RHIT) will be required or be willing to obtain within six months.

• Knowledge of utilization review, quality assurance procedures, and experience with Inter Qual or Milliman.
• Bachelor’s degree in Health Care Administration, Business Administration, or related field.
• Knowledge of medical auditing, federal healthcare program policies, ICD‑10, CPT, HCPCS, DRG coding.
• Certified in Healthcare Compliance (CHC) from HCCA or willing to obtain within six months.

Remote work options are available. The University of Utah values candidates with experience working with students and patients from all backgrounds and a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patients. Veterans’ preference is extended. Reasonable accommodations for disabilities will be provided. The University of Utah is an affirmative action and equal opportunity employer and does not discriminate based on protected veteran status, disability, sex, gender identity, gender expression, pregnancy, or any other protected class as required by law.