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Carelon Audit Jobs (NOW HIRING)

SM Staffing

Compliance Director

Suffern, NY

... HIPAA, audit response, regulatory inquiries, and Joint Commission / AHCA compliance posture ... Carelon), including authorization workflows, concurrent review processes, and appeals -- Experience ...

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How much do carelon audit jobs pay per year?

As of Aug 9, 2026, the average yearly pay for carelon audit in the United States is $71,776.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,500.00 and $81,500.00 per year, depending on experience, location, and employer.

What is the difference between Carelon Audit vs Carelon Compliance Analyst?

AspectCarelon AuditCarelon Compliance Analyst
Required CredentialsCPA, CIA, or related certifications often preferredCompliance certifications like CCEP or CCEP-I beneficial
Work EnvironmentAuditing financial and operational processes within healthcareMonitoring and ensuring adherence to healthcare regulations
Employer & Industry UsageUsed in healthcare organizations for financial auditsUsed in healthcare for regulatory compliance and policy adherence

Carelon Audit focuses on evaluating financial and operational processes through audits, often requiring accounting or auditing credentials. Carelon Compliance Analyst concentrates on ensuring healthcare practices meet regulatory standards, emphasizing compliance certifications. Both roles operate within healthcare organizations but serve different functions—one audits financials, the other ensures regulatory adherence.

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What cities are hiring for Carelon Audit jobs? Cities with the most Carelon Audit job openings:
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Carelon Audit jobs near you
Infographic showing various Carelon Audit job openings in the United States as of August 2026, with employment types broken down into 75% Full Time, and 25% Part Time. Highlights an 100% In-person job distribution, with an average salary of $71,776 per year, or $34.5 per hour.

PRP Rehabilitation Specialist / Supervisor

Renewing Me Behavioral Health Solution

Parkville, MD • On-site

Part-time

Re-posted 26 days ago

Job description

About RMBHS


Renewing Me Behavioral Health Solutions (RMBHS) is a CARF-accredited, Maryland-licensed behavioral health organization providing Outpatient Mental Health, Psychiatric Rehabilitation (PRP), Substance Use Disorder Treatment, and Intensive Outpatient Services.


We are seeking an experienced Rehabilitation Specialist / PRP Supervisor to provide leadership, oversight, staff supervision, rehabilitation assessments, and program support for our Adult and Minor PRP programs.


Position Summary

The Rehabilitation Specialist / PRP Supervisor is responsible for overseeing psychiatric rehabilitation services, conducting intakes and rehabilitation assessments, developing Individual Rehabilitation Plans (IRPs), supervising Family Service Coordinators (FSCs), facilitating psychoeducational groups, and ensuring compliance with Medicaid, Carelon, COMAR, and CARF standards.

The Rehabilitation Specialist serves as the clinical and programmatic lead for PRP services and supports staff in delivering high-quality rehabilitation services.


Essential Duties and Responsibilities


Program Oversight

  • Provide oversight of Adult and Minor PRP services.
  • Assign and manage caseload distribution among Family Service Coordinators.
  • Monitor service delivery and ensure compliance with program requirements.
  • Review productivity, documentation, and service outcomes.
  • Participate in program development and quality improvement activities.

Intake, Assessment & Treatment Planning

  • Complete PRP intakes and rehabilitation assessments.
  • Develop, review, and approve Individual Rehabilitation Plans (IRPs).
  • Conduct annual reassessments and treatment plan updates.
  • Ensure rehabilitation goals are individualized, measurable, and recovery-oriented.

Staff Supervision & Training

  • Provide supervision and guidance to Family Service Coordinators and rehabilitation staff.
  • Conduct regular chart reviews and documentation audits.
  • Provide coaching on engagement strategies, rehabilitation interventions, and compliance requirements.
  • Assist with onboarding and training of new PRP staff.

Group Facilitation

  • Facilitate psychoeducational, recovery-oriented, life skills, and wellness groups.
  • Develop group activities and curriculum that support rehabilitation goals.
  • Promote consumer engagement and community integration through structured activities.

Compliance & Documentation

  • Review documentation for accuracy and compliance.
  • Monitor authorization requirements and service utilization.
  • Complete Carelon authorizations and reauthorizations.
  • Support CARF, Medicaid, and COMAR compliance activities.
  • Participate in audits and quality assurance reviews.


Community & Treatment Team Collaboration

  • Collaborate with therapists, prescribers, schools, probation officers, DSS, and community partners.
  • Participate in multidisciplinary treatment team meetings.
  • Assist with identifying resources and supports for consumers and families.


Qualifications Required


One of the following:

  • CPRP (Certified Psychiatric Rehabilitation Practitioner)
  • LCPC
  • LGPC
  • LCSW-C
  • LMSW

AND

  • Minimum of two years of experience in psychiatric rehabilitation, behavioral health, case management, or community-based services.
  • Experience completing rehabilitation assessments and IRPs.
  • Experience supervising staff or providing leadership within a behavioral health program.
  • Knowledge of Maryland PRP regulations and rehabilitation services.
  • Reliable transportation.

Preferred

  • Experience with Adult and Minor PRP programs.
  • Experience with Carelon authorizations.
  • Experience with ICANotes EMR.
  • Experience with CARF accreditation standards.