Registered Nurse (RN) Clinical Compliance Auditor- Remote

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth ’s clinical operations, utilization management activities, and delegated services comply with regulatory requirements, client contractual obligations, and internal clinical standards. This role serves as a senior clinical compliance subject matter expert and performs advanced auditing, monitoring, and compliance validation activities to ensure adherence to Utilization Management (UM) and Population Health Management (PHM) Plans, Managed Services Agreements (MSAs), and value-based care program requirements. In addition to conducting audits, this role provides leadership through mentorship, process improvement, audit program development, and cross-functional collaboration. The Clinical Compliance Auditor II partners closely with Clinical Leadership, Compliance, and Operations teams to identify risks, support regulatory readiness, and ensure clinical services meet the highest standards of accuracy, quality, and compliance. This position operates with a high degree of autonomy, exercising independent judgment to evaluate compliance risks, support operational improvements, and strengthen Guidehealth ’s clinical compliance infrastructure. As a growing and innovative organization, we operate with a high degree of agility. Employees are expected to adapt to evolving business needs, step in to support cross-functional initiatives, and contribute beyond traditional role boundaries when needed. This collaborative