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Vice President Medicare Rac Audit Jobs (NOW HIRING)

Alignment Healthcare

VP, Internal Audit

Orange, CA

Together. The VP, Internal Audit is a highly visible senior leadership role responsible for ... Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter ...

Alignment Healthcare

VP, Internal Audit

Orange, CA · On-site

Together. The VP, Internal Audit is a highly visible senior leadership role responsible for ... Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter ...

Coralvita

Vice President, Finance

Irving, TX · On-site

... GAAP, CMS, Medicare, Medicaid, HIPAA, and applicable federal and state regulations. * Direct ... Oversee accounting, treasury, cash management, and external audits while ensuring sound financial ...

Coralvita

Vice President, Finance

Irving, TX · On-site

... GAAP, CMS, Medicare, Medicaid, HIPAA, and applicable federal and state regulations. * Direct ... Oversee accounting, treasury, cash management, and external audits while ensuring sound financial ...

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Vice President Medicare Rac Audit information

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$43.5K

$157.5K

$277.5K

How much do vice president medicare rac audit jobs pay per year?

As of Jul 27, 2026, the average yearly pay for vice president medicare rac audit in the United States is $157,532.00, according to ZipRecruiter salary data. Most workers in this role earn between $115,000.00 and $190,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Vice President, Medicare RAC Audit, and why are they important?

To thrive as a Vice President, Medicare RAC Audit, you need deep expertise in healthcare compliance, audit management, and Medicare regulations, typically supported by a relevant degree and substantial leadership experience. Proficiency with audit software, data analytics tools, and familiarity with CMS RAC guidelines and regulatory reporting systems is essential. Exceptional analytical thinking, strategic leadership, and strong communication skills are crucial for guiding teams and managing complex audits. These skills ensure regulatory compliance, minimize financial risk, and drive effective audit outcomes for healthcare organizations.

How does the Vice President Medicare RAC Audit collaborate with other departments to ensure compliance and successful audit outcomes?

The Vice President Medicare RAC Audit works closely with departments such as compliance, legal, revenue cycle, and clinical operations to coordinate audit responses and ensure regulatory adherence. This role often leads cross-functional meetings to review audit findings, develop action plans, and implement process improvements. Effective communication and collaboration are essential, as the VP must translate complex audit requirements into clear operational tasks and foster a culture of compliance throughout the organization. Additionally, the VP regularly updates executive leadership on audit trends and risk areas to inform strategic decision-making.

What does a Vice President Medicare RAC Audit do?

A Vice President Medicare RAC Audit oversees the compliance and management of Recovery Audit Contractor (RAC) audits within a healthcare organization. They are responsible for developing strategies to address RAC audits, ensuring all Medicare billing and documentation adhere to regulations, and leading teams that respond to audit findings. This role often involves coordinating between departments, implementing process improvements, and staying updated on changing Medicare audit rules to minimize financial risk for the organization.

What is the difference between Vice President Medicare Rac Audit vs Medicare RAC Auditor?

AspectVice President Medicare RAC AuditMedicare RAC Auditor
CredentialsAdvanced degrees, certifications in healthcare compliance, auditing, or Medicare regulationsCertifications like RAC-CR, CPC, or similar auditing credentials
Work EnvironmentExecutive-level, strategic planning, overseeing teams, policy developmentField or office-based, performing audits, data analysis, compliance reviews
Employer & Industry UsageHealthcare organizations, insurance companies, government agencies at a senior levelMedicare contractors, healthcare providers, auditing firms

The Vice President Medicare RAC Audit typically oversees and directs Medicare RAC audit programs at a strategic level, focusing on compliance and policy. In contrast, a Medicare RAC Auditor conducts the actual audits, reviews claims, and ensures adherence to Medicare regulations. Both roles require strong knowledge of Medicare rules, but differ in scope, responsibilities, and seniority.

What cities are hiring for Vice President Medicare Rac Audit jobs? Cities with the most Vice President Medicare Rac Audit job openings:
What are the most commonly searched types of Medicare Rac Audit jobs? The most popular types of Medicare Rac Audit jobs are:
What states have the most Vice President Medicare Rac Audit jobs? States with the most job openings for Vice President Medicare Rac Audit jobs include:
Vice President Medicare Rac Audit jobs near you
Project Mgr. RAC

Project Mgr. RAC

University Medical Center of El Paso

El Paso, TX • On-site

Full-time

Posted 12 days ago

University Medical Center Of El Paso rating

6.7

Company rating: 6.7 out of 10

Based on 36 frontline employees who took The Breakroom Quiz

637th of 1,051 rated hospitals

Job description


The RAC Project Manager performs activities related to the coordination and management of the Medicare RAC Program involving audit defense and claims appeals. Works closely with Case Management staff for determination of medical necessity status. Monitors processes and implements procedures as needed to ensure compliance with federal guidelines involving reimbursement for services performed. Acts as a resource to provide board level reports of program status related to job related functions.
Required Skills:
  1. Knowledge of Medicare RAC program, audit defense and claims appeals; medical necessity status determinations; EMTALA, Never Events, HACs, or any other patient care regulatory elements.
  2. Knowledge base in medical terminology, healthcare coding processes including CPT4, HCPCS, ICD-9
  3. Knowledge of Medicaid and Medicare, HIPAA, TJC regulations, and healthcare laws and regulations.
  4. Knowledge and ability to interpret government regulations, medical documentation,
  5. Knowledge and ability to identify fraud, abuse, and penalties for documentation and coding violations based on governmental guidelines.
  6. Knowledge and ability to apply strong analytical skills, data management and operational process, and computer skills involved in the preparation of reports and presentations.
  7. Knowledge of complexities of an Academic Medical Center. Involves others appropriately in consultations and decisions.
  8. Ability to operate successfully in a constantly changing, fast-paced environment.
  9. Ability to apply clinical expertise to review and audit medical records.
  10. Ability to apply excellent interpersonal communication and negotiation skills.
  11. Ability to apply written and oral communication skills.
  12. Ability to work with people of all social, economic, and cultural backgrounds. Exemplifies an approachable style that elicits open communication with Associates, Management staff, and Physicians. Strong interpersonal skills demonstrating the ability to listen effectively.
  13. Ability to be flexible, open-minded and adaptable to change.
  14. Ability to apply strong organizational and time management skills to multi-task in a fast paced environment and prioritize tasks and role components.
  15. Ability to and coordinate with different departments and entities simultaneously in order to carry out auditing function to meet deadlines and goals.
  16. Ability to work independently and exercise sound judgment in interactions with members of the workforce, contracted vendors, and patients/families. Ability to maintain a high degree of credibility, independence, integrity, confidentiality and trust required.
  17. Ability to develop partnerships, teamwork and good working relationships and maintain an open, participative communication style.
  18. Bilingual English/Spanish preferred, culturally sensitive.

Required Experience:
Work Experience:
Three years of experience in healthcare project or program management required. Experience in case management, coding, auditing, healthcare fraud investigation, and clinical documentation preferred.
License/Registration/Certification
RN License preferred;
Certified Case Manager (CCM), Certified Professional Medical Auditor (CPMA), or Certified Medical Audit Specialist (CMAS) obtained within two years of accepting position.
Education/Training
Bachelors degree required; preferably in Business, Medical Records Technology, Health Services Administration, Nursing or related field. Masters degree preferred.

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