Director of Payor Audit & Regulatory Defense

The Opportunity

Aeroflow Health is seeking a seasoned Director of Payor Audits & Regulatory Defense to lead the company through a critical period of audit intensity, regulatory scrutiny, and program maturity.

This role is not about maintaining a steady-state audit function, but about raising the bar and building a durable audit program capable of operating across 50 states, complex payor requirements, and heightened government oversight.

Reporting to the Associate General Counsel, this leader will own government and commercial payor audits, partner closely with Legal and Compliance, and build a strong internal audit program once immediate risks are contained.

This is a high-impact, high-visibility role for someone who thrives in ambiguity, understands the art and science of audits, and is not afraid to step into complexity.

Your Primary Responsibilities

External & Government Audits

• Lead all external audits, including Medicaid, Medicare, and commercial payors
• Serve as the primary point of contact for commercial and payor audits
• Oversee audit responses, rebuttals, corrective action plans, and appeals
• Partner with Legal to ensure the company speaks with one voice during audits
• Track audit outcomes, recoupments, pre-pay activity, and financial exposure

Internal Audit Program Development

• Design and implement a robust internal audit and monitoring program, built from the ground up
• Use audit findings to inform policy updates, training, and operational improvements
• Identify root causes and drive sustainable remediation across teams

Risk, Strategy, & Leadership

• Advise executive leadership on audit risk, mitigation strategies, and resource needs
• Navigate audits across multiple state Medicaid manuals, understanding the nuance and variation by state
• Lead and develop audit staff, setting expectations and raising performance
• Operate effectively within a large, multi-state, national organization
• Other job duties as assigned

Skills for Success

The strongest candidates for this role will demonstrate:

• Command presence in high-stakes environments, with the ability to represent Aeroflow confidently and credibly in government and commercial audit settings
• Exceptional written and verbal communication skills, particularly in drafting audit responses, rebuttals, and executive-level summaries
• Strong judgment and decision-making ability, especially when navigating ambiguity, incomplete guidance, or competing regulatory interpretations
• Analytical rigor, with the ability to assess audit findings, quantify exposure, and translate risk into clear business impact
• Cross-functional influence, including the ability to partner effectively with Legal, Compliance, Operations, and Executive Leadership
• Root-cause orientation, focused not just on closing audits but on preventing recurrence through sustainable remediation
• Organizational and prioritization skills to manage multiple audits, timelines, and stakeholders simultaneously
• Leadership and coaching capability, with experience developing audit talent and raising performance standards across a team
• Balance of precision and pragmatism, knowing when to apply strict interpretation and when to navigate toward practical, defensible outcomes

Required Qualifications

• Direct government audit experience, with strong preference for Medicaid
• Experience auditing DME or similarly regulated healthcare environments
• Hands-on experience managing audits across multiple states
• At least 5+ years of pure audit experience, with leadership responsibility
• Willingness to travel to Headquarters (Asheville, NC) on a monthly basis

You might also have

• Certified Fraud Examiner (CFE) credential
• Prior work with or within a Medicaid Fraud Control Unit (MFCU) or equivalent government audit authority
• CHC certification
• Experience enhancing an audit program

What we look for

This role is best suited for someone who:

• Thrives under pressure
• Enjoys solving complex problems with limited precedent
• Is comfortable making judgment calls when the answer is not obvious
• Knows how to lead people through uncertainty
• Can balance precision with pragmatism
• Wants to leave something stronger than they found it

What Aeroflow Offers

Competitive Pay, Health Plans with FSA or HSA options, Dental, and Vision Insurance, Optional Life Insurance, 401K with Company Match, 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s), Additional Parental benefits to include fertility stipends, free diapers, breast pump, Paid Holidays, PTO Accrual from day one, Employee Assistance Programs and SO MUCH MORE!!

#MPC-1