Manager of Compliance Auditing

About The Company

Provider Resources Inc. (PRI) is looking for a Manager of Compliance Auditing to own our IDR determination audit function. This is an individual contributor role for a compliance professional with deep IDR and No Surprises Act knowledge who can audit case-level determinations, identify systemic patterns, and drive corrective action in a fast-scaling, CMS-regulated environment.

What you will do

• Audit IDR operational determinations for accuracy, consistency, and CMS regulatory compliance
• Identify patterns across reviewers, case types, and program lines and escalate systemic findings
• Maintain audit documentation and findings reports to URAC and CMS standards
• Track findings through CAPA to resolution
• Support external URAC and CMS audit preparation
  
  

What we are looking for

• 5 to 8 years compliance or auditing experience in a healthcare or regulated environment
• Direct knowledge of the IDR process, No Surprises Act, and CMS IDR regulations — IDRE or IRO experience preferred
• Experience conducting structured compliance audits and producing findings reports
• Analytical — comfortable identifying patterns across large case volumes
• URAC or NCQA audit familiarity preferred
  
  

Why PRI

• Meaningful work — PRI processes payment disputes that directly protect patients from unexpected medical bills under the No Surprises Act
• Growth stage — we are building the systems, processes, and team that will define PRI for the next decade
• Skills framework — every role at PRI has a defined skills ontology with clear growth paths and Udemy development pathways
• Lean and direct — decisions get made, work is visible, and contributions matter
  
  

PRI is an equal opportunity employer. We evaluate candidates on demonstrated skills and capability.