Sr. Compliance Auditor

Umpqua Health is recruiting for a Sr. Compliance Auditor to support our mission of delivering high-quality, ethical, and compliant healthcare services to our members. In this role, you will play a key part in ensuring organizational adherence to regulatory requirements, internal policies, and industry standards. Through audits, risk assessments, and process reviews, you’ll help protect the integrity of our operations and ensure we meet all federal, state, and contractual obligations. This is an excellent opportunity for a compliance professional who is passionate about accountability, transparency, and continuous improvement in the healthcare sector. 

Your Impact: 

• Plan, coordinate, and execute internal audits across departments to assess compliance with federal and state regulations, Oregon Health Plan (OHP) requirements, and internal policies. 

• Conduct and oversee high-level investigations into financial misconduct, healthcare fraud, and regulatory violations.

• Analyze complex financial and healthcare records to identify patterns of fraudulent activity.

• Gather evidence, interview witnesses, and prepare detailed investigative reports.

• Collaborate with law enforcement agencies, legal teams, and regulatory bodies.

• Provide expert testimony in legal proceedings and regulatory hearings.

• Develop strategies for fraud prevention and risk mitigation.

• Maintain strict confidentiality and adhere to ethical standards in all investigative activities.

• Stay updated on industry trends, legal developments, and emerging fraud schemes.
  Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values. 

Your Credentials: 

Required Qualifications:

• AFHI (Accredited Financial and Healthcare Investigator) credential.

• Bachelor's degree in Criminal Justice, Forensic Accounting, Healthcare Administration, or a related field (Master’s preferred).

• Minimum of five (5) years of experience in financial or healthcare investigations.

• Strong knowledge of laws, regulations, and compliance standards in financial and healthcare industries.

• Proficiency in investigative tools, data analysis, and fraud detection software.

• Excellent communication, analytical, and problem-solving skills.

• Ability to work independently and handle complex investigations with professionalism.

About Umpqua Health

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.