Operations & Compliance Auditor
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Operations & Compliance Auditor Full Time Professional Orange Office, Orange, CA, US
Operations & Compliance Auditor Healthcare is increasingly unaffordable for many Americans. For those who can afford it, they are in a health insurance system that has become more confusing, restrictive, and lower value with each passing year. Here at WeShare our mission is to bring better healthcare to America at a better price. We offer consumers a member-to-member health sharing program that is much more cost effective than standard health insurance while providing access to over 1.2 million physicians across the country. Come join us on this important journey to create the next generation of healthcare!
WeShare is a rapidly growing faith-based nonprofit that strives to do good while delivering great and affordable healthcare. The company is led by senior executives with an extensive background in both for-profit and not-for-profit enterprises. If you have a bias for action, enjoy challenges, and love creating impact in a massive industry, WeShare might be the place for you!
About this role The Operations & Compliance Auditor ensures accuracy, compliance, and efficiency across call-center and operational workflows. This role conducts advanced, risk-based audits across multiple communications channels, identifies systemic gaps, and provides strategic insights that protect revenue, data integrity, and member experience.
Operating with minimal supervision, the auditor serves as a subject matter expert, escalation resource, and partner to leadership on quality, compliance, and process improvement initiatives.
Key Responsibilities Quality Oversight & Multi-Channel Auditing Conduct risk-based audits across calls, case documentation, emails, texts, escalations, exceptions, and retention/saves
Perform high-risk and escalated audits requiring independent judgment and regulatory awareness
Identify systemic process gaps, compliance deviations, terminology inconsistencies, operational risks, and provide actionable recommendations
Perform peer-to-peer audits and audit the auditors
Operational Expertise & Escalation Support Serve as a subject matter expert for eligibility, application outcomes, cancellations, reinstatements, saves, and compliance workflows
Act as an escalation resource for complex or high-risk cases
Ensure adherence to internal protocols, documentation standards, and compliance requirements
Proactively identify and resolve operational or compliance issues with a solutions-oriented approach
Trend Analysis & Strategic Insight Analyze audit trends and performance metrics to support leadership decision-making
Identify recurring errors, blind spots, and systemic issues and contribute to process improvement planning
Provide complete, accurate reporting with clear recommendations
Participate in calibration sessions to ensure consistent scoring
Support special projects and implementation of safeguards that protect revenue and reputation
Reporting, Documentation, & System Optimization Maintain accurate audit logs and documentation
Support development of audit scorecards, QA workflows, and reporting frameworks
Participate in system optimization initiatives to improve operational efficiency
Reliability & Performance Consistently meet or exceed KPIs with minimal supervision
Demonstrate strong follow-through, confidentiality, and discretion with sensitive data
Maintain a solutions-oriented mindset in resolving operational challenges
Required Qualifications HS Diploma/GED or higher
1+ year in QA, auditing, compliance review, call-center QA, or customer service
Experience auditing calls, written correspondence, and case documentation
Strong analytical skills with trend and root-cause identification
High attention to detail, risk assessment ability, and independent judgment
Strong written and verbal communication skills
Proven reliability, confidentiality, and ability to provide objective feedback
Excel proficiency and experience creating structured reports
Demonstrated process-improvement and system-optimization experience
Strong organizational skills and ability to work with minimal supervision
Preferred Qualifications Experience in healthcare, health-sharing, insurance, or non-profit environments
Familiarity with compliance frameworks and HIPAA
Bilingual (Spanish/English) and tech-savvy
What we offer Competitive hourly and benefits package, including health, life dental, and vision insurance, 403(b) with company match, and time off
The chance to make a meaningful impact in the lives of individuals and families seeking affordable, faith-based healthcare solutions
Great culture where you work with the founders and key stakeholders in a relaxed, but innovative atmosphere
UHSM is an Equal Opportunity Employer. Our business is fast-paced and will continue to evolve. As such, the duties and responsibilities of this role may be changed as directed by the Company at any time to promote and support our business needs. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law and will not be discriminated against on the basis of disability.
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