Senior Compliance Analyst; Remote Texas; Office of Institutional Compliance
McAllen, Hidalgo County, Texas, 78501, USA
Listed on 2026-10-04
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Healthcare
Healthcare Compliance
Bachelor’s degree and four (4) years of experience in an audit or investigation function preferred.
Job Summary:
To audit and/or review complex systems or operations in order to evaluate and report on compliance matters and the adequacy, effectiveness, and comprehensiveness of compliance, accounting, management, or other controls in these operations and to ensure compliance with applicable federal and state laws, rules, and regulations.
Job Duties:
Coordinates and conducts audits of compliance activities of UTMB departments for the Office of Institutional Compliance (OIC) to ensure compliance with applicable federal and state laws, rules, and regulations.
Functional Specialty Responsibilities:
(One or more of the following specialty areas may be assigned based on organizational need and employee expertise.)
Conflict of Interest (COI):
- Reviews and analyzes conflict of interest disclosures for compliance with institutional policies and applicable federal and state regulations.
- Conducts assessments of potential financial, research, and professional conflicts of interest and recommends appropriate management strategies.
- Coordinates with institutional stakeholders to develop, implement, and monitor conflict management plans.
- Maintains documentation, tracking, and reporting related to COI disclosures, reviews, and resolutions.
- Provides guidance and education to faculty, staff, and leadership regarding COI requirements and disclosure obligations.
Compliance Risk Assessment:
- Assists in the development, implementation, and maintenance of the institutional compliance risk assessment program.
- Conducts enterprise and departmental compliance risk assessments to identify, evaluate, and prioritize regulatory and operational risks.
- Analyzes data, trends, audit findings, and regulatory changes to identify emerging compliance risks and recommend mitigation strategies.
- Collaborates with institutional leadership to develop corrective action plans and monitor remediation efforts.
- Prepares risk assessment reports, dashboards, and presentations for leadership and compliance committees.
Fraud & Abuse Hotline/Investigations:
- Assists with the administration and coordination of compliance hotline and case management activities for the Office of Institutional Compliance.
- Reviews and processes hotline reports and compliance concerns for documentation, tracking, routing, and follow-up.
- Maintains case files, documentation, data entry, and related records in accordance with institutional standards and confidentiality requirements.
- Coordinates meetings, communications, follow-ups, and status updates related to compliance reviews and case management activities.
- Monitors case activity, supports timely follow-up, and assists with reporting, trend analysis, and process improvement initiatives.
Billing and Coding Compliance:
- Conducts billing compliance analytics and prepares reports to support risk-based work plans, including monitoring and reporting of audit findings, impact areas, and corrective actions taken.
- Monitors and evaluates regulatory updates, payer guidance, and OIG Work Plan items to assess organizational impact and inform risk prioritization.
- Collaborates with operational departments to support corrective action plans, education, and process improvement initiatives related to billing and coding compliance.
- Utilizes compliance tools (e.g., MDaudit) to support risk assessment, trending, audit support, and compliance oversight activities.
- Assists with analysis, trending, reporting, and maintenance of audit documentation related to billing and coding compliance activities.
HIPAA/Privacy Compliance:
- Assists with monitoring and reviewing compliance with…
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