Compliance Auditor

Job Summary

The Compliance Auditor supports the University of Maryland Medical System's (UMMS) compliance program by conducting risk-based compliance audits, monitoring activities, and regulatory reviews designed to evaluate adherence to applicable federal and state laws, regulations, reimbursement and documentation requirements, UMMS policies and procedures, and established compliance controls. Under the direction of Internal Audit and Enterprise Risk Management leadership, the position supports execution of the compliance work plan and provides objective, well-supported information regarding compliance risks, control effectiveness, and opportunities for corrective action and process improvement.

Primary Responsibilities

Compliance Risk Assessment and Work Plan Support

• Supports compliance risk assessments and maintenance of the compliance risk register by coordinating risk identification, documenting clear risk statements, analyzing relevant information, tracking mitigation activities, updating risk status, maintaining supporting documentation, and preparing summary reporting for leadership and governance committees.
• Supports execution of the compliance work plan by tracking planned auditing, monitoring, education, policy, regulatory, and follow-up activities; maintaining timelines and status information; identifying delays or barriers; and assisting with completion reporting.
• Monitors healthcare compliance developments and evaluates potential organizational impact, including changes involving privacy, documentation, coding, billing, reimbursement, research, physician relationships, fraud, waste and abuse, and other assigned compliance risk areas.
• Collaborates with Compliance leadership and operational stakeholders to clarify regulatory and program expectations, identify emerging risks, and prioritize compliance activities based on risk and organizational needs.

Compliance Auditing and Monitoring

• Plans, coordinates, and performs risk-based compliance audits, monitoring activities, and reviews to evaluate adherence to applicable laws, regulations, policies, procedures, documentation standards, and established compliance controls.
• Develops or follows approved audit objectives, scope, work steps, sampling approaches, and procedures and adjusts activities in consultation with Compliance leadership when circumstances warrant.
• Conducts interviews, reviews policies and supporting documentation, performs data analysis, and completes timely medical record reviews across relevant UMMS functions and member organizations.
• Gathers, organizes, and evaluates information from multiple sources; identifies potential compliance concerns, root causes, trends, outliers, and control gaps; draws logical conclusions; and determines when escalation or additional review is appropriate.
• Maintains complete, accurate, organized, and audit-ready documentation of procedures performed, information reviewed, identified issues, actions taken, conclusions, and resolutions in designated systems, trackers, and repositories.

Reporting, Communication, and Follow-Up

• Develops clear, concise, objective, and well-supported compliance findings, written summaries, reports, dashboards, and recommendations for departments, Compliance leadership, senior leaders, and governance committees.
• Communicates compliance audit and monitoring activities, results, trends, and required actions to affected stakeholders in understandable terms and participates in status, validation, and closing discussions.
• Supports administration of management action plan processes, including intake, documentation, assignment and due-date tracking, evidence collection, follow-up, closure support, escalation of barriers, and validation that corrective actions appropriately address identified risks.
• Partners with operational leaders to clarify management action plan expectations, monitor remediation progress, identify barriers to closure, and support timely and sustainable implementation.
• Develops and maintains dashboards, trackers, and recurring reports related to compliance risks, audit and monitoring results, corrective actions, work plan progress, and recurring themes.
• Prepares materials and provides governance support for compliance committees and other leadership forums, including status updates, summaries of open items, and documentation of work plan and corrective action progress.

Regulatory, Policy, and External Review Support

• Supports responses to government audits, reviews, inquiries, and other external compliance examinations by coordinating requests, gathering and validating documentation, tracking deliverables, and escalating issues in accordance with direction from Compliance leadership and Legal, as applicable.
• Assists with developing, reviewing, and maintaining compliance-related policies, procedures, guidance, and audit tools to promote alignment with current regulatory requirements and program expectations.
• Provides policy and compliance-related guidance within the scope of the role and refers matters requiring legal interpretation, specialized expertise, or leadership decisions to the appropriate resource.
• Maintains knowledge of applicable federal and state requirements, accreditation standards, payer requirements, UMMS policies, and compliance program expectations and applies them appropriately in assigned reviews.

Stakeholder Engagement, Improvement, and Professional Accountability

• Builds effective working relationships across UMMS and collaborates with Compliance, Privacy, Legal, Revenue Cycle, Health Information Management, Finance, Human Resources, Information Services, clinical departments, and operational leaders, as appropriate to assigned work.
• Participates in departmental initiatives, special projects, and process improvement efforts that strengthen compliance program operations, standardize workflows, improve visibility into risk, and support evolving priorities.
• Identifies opportunities to improve compliance auditing and monitoring methodologies, templates, analytics, dashboards, tools, reporting practices, and stakeholder experience and supports implementation of approved improvements.
• Maintains professional knowledge through training, seminars, professional publications, participation in relevant organizations, and continued development or maintenance of applicable credentials.
• Acts with integrity and high ethical standards, supports a culturally welcoming and inclusive work environment, protects patient and organizational confidentiality, and handles sensitive information in accordance with UMMS policies and applicable requirements.
• Plans and prioritizes assigned work, manages multiple deadlines, communicates status and barriers proactively, completes required organizational activities timely, accepts constructive feedback, and supports team and department priorities.
• Recognizes and communicates ethical, legal, regulatory, and compliance concerns through established channels and performs other compliance-related duties reasonably related to the position, qualifications, and competencies.