Global Technical Talent, an Inc. 5000 Company
SR Health Plan Auditor
Global Technical Talent, an Inc. 5000 Company, Los Angeles, California, United States, 90079
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Global Technical Talent, an Inc. 5000 Company provided pay range
This range is provided by Global Technical Talent, an Inc. 5000 Company. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$50.53/hr - $55.53/hr Primary Job Title: Senior Health Plan Auditor Location :CA(Hybrid) Date Posted: 7/16/2025 Employment Type:
3-month Contract Salary Range:
$50.53 - $55.53/Hr Job Summary
The Senior Health Plan Auditor is a hybrid role and is responsible for all aspects of planning, execution, reporting, and corrective action plans, monitoring of financial solvency and claims processing compliance for specialty health plans and vendors. These audits are intended to ensure that Client delegates are in compliance with regulatory requirements and Client contractual agreements across all lines of business. The position is responsible for the DMHC claims data submissions for Client and its Plan Partners and delegates each quarter and annually. Primarily responsible for the creation, review, and submission of departmental policies and procedures annually. Serves as a subject matter expert and mentor for other staff.
Duties
Performs financial audits and/or financial analyses for Specialty Health Plans. Performs financial analyses or vendor management for Client vendors. Performs claims audits for Specialty Health Plans and vendors. Provides timely and accurate deliverables to ensure financial solvency and claims processing compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors. Assists in the creation and implementation of standardized Specialty Health Plans and vendors' workpapers and reporting templates. Responsible for the documentation and maintenance of the Financial Compliance Department's policies and procedures. Responsible for the collection and completion of the quarterly and annual Department of Managed Health Care (DMHC) filing submissions. Being cross-trained on financial solvency reviews for PPGs, PPs, and capitated hospitals. Serves as primary contact and liaison for the Centers for Medicare and Medicaid Services (CMS) claim audit section ofdelegates. Annually reviews and updates the department's Policies and Procedures (P&Ps). Ensures that any new or updated Policy and Procedure is reviewed and approved by management prior to submission. Accountable for the completion of requests from the Legal Department, Delegation Oversight's monitoring, oversight and reporting. Serves as a subject matter expert in assigned areas and cross-training initiatives. Responsible for the overall communication and collaboration with interdepartmental personnel, leadership, specialty health plans, and vendors. Supports the design, implementation, and reporting of special projects. Supports the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications. Supports the assessment, communication, and implementation of regulatory requirements that may impact internal processes. Supports the formalization of key internal processes and monitoring tools with desktop procedures and applicable policies and procedures development. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Provides training, recommends process improvements, and mentors junior-level staff, department interns, etc. as needed. Performs other duties as assigned. Education Required
Bachelor's Degree in Accounting or Related Field In lieu of degree, equivalent education and/or experience may be considered. Experience Required
At least 3 years of experience in conducting financial audits. At least 5 years of related experience in the managed health care industry. Minimum of 2 years of accounting experience. Skills Required
Strong analytical and critical thinking skills. Action-oriented, self-starter, and excellent motivator. Excellent verbal and written communication skills. Able to prioritize assignments and able to work independently with minimal supervision. Ability to interface professionally with both internal and external customers at all levels of the organization. Proficiency in Microsoft Office (Excel, PowerPoint, and SharePoint). Licenses/Certifications
Must hold one of the following certifications:
Certified Public Accountant (CPA) Certified Management Accountant (CMA) Certified Internal Auditor (CIA) Certified Fraud Examiner (CFE) Contract Benefits
Medical, Vision, and Dental Insurance Plans 401k Retirement Fund About the Hiring Company
Not-for-profit healthcare organization focused on serving vulnerable and underserved communities in Los Angeles. Seeking entrepreneurial professionals with a passion for healthcare and business process improvement. Join our team and make a positive impact.
About GTT
GTT is a minority-owned staffing firm and a subsidiary of Chenega Corporation, a Native American-owned company in Alaska. As a Native American-owned, economically disadvantaged corporation, we highly value diverse and inclusive workplaces. Our clients are Fortune 500 banking, insurance, financial services, and technology companies, along with some of the nation’s largest life sciences, biotech, utility, and retail companies across the US and Canada. We look forward to helping you land your next great career opportunity! 25-23595 #gttjobs Seniority level
Seniority level Entry level Employment type
Employment type Contract Job function
Job function Accounting/Auditing and Finance Industries Staffing and Recruiting Referrals increase your chances of interviewing at Global Technical Talent, an Inc. 5000 Company by 2x Get notified about new Senior Auditor jobs in
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This range is provided by Global Technical Talent, an Inc. 5000 Company. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$50.53/hr - $55.53/hr Primary Job Title: Senior Health Plan Auditor Location :CA(Hybrid) Date Posted: 7/16/2025 Employment Type:
3-month Contract Salary Range:
$50.53 - $55.53/Hr Job Summary
The Senior Health Plan Auditor is a hybrid role and is responsible for all aspects of planning, execution, reporting, and corrective action plans, monitoring of financial solvency and claims processing compliance for specialty health plans and vendors. These audits are intended to ensure that Client delegates are in compliance with regulatory requirements and Client contractual agreements across all lines of business. The position is responsible for the DMHC claims data submissions for Client and its Plan Partners and delegates each quarter and annually. Primarily responsible for the creation, review, and submission of departmental policies and procedures annually. Serves as a subject matter expert and mentor for other staff.
Duties
Performs financial audits and/or financial analyses for Specialty Health Plans. Performs financial analyses or vendor management for Client vendors. Performs claims audits for Specialty Health Plans and vendors. Provides timely and accurate deliverables to ensure financial solvency and claims processing compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors. Assists in the creation and implementation of standardized Specialty Health Plans and vendors' workpapers and reporting templates. Responsible for the documentation and maintenance of the Financial Compliance Department's policies and procedures. Responsible for the collection and completion of the quarterly and annual Department of Managed Health Care (DMHC) filing submissions. Being cross-trained on financial solvency reviews for PPGs, PPs, and capitated hospitals. Serves as primary contact and liaison for the Centers for Medicare and Medicaid Services (CMS) claim audit section ofdelegates. Annually reviews and updates the department's Policies and Procedures (P&Ps). Ensures that any new or updated Policy and Procedure is reviewed and approved by management prior to submission. Accountable for the completion of requests from the Legal Department, Delegation Oversight's monitoring, oversight and reporting. Serves as a subject matter expert in assigned areas and cross-training initiatives. Responsible for the overall communication and collaboration with interdepartmental personnel, leadership, specialty health plans, and vendors. Supports the design, implementation, and reporting of special projects. Supports the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications. Supports the assessment, communication, and implementation of regulatory requirements that may impact internal processes. Supports the formalization of key internal processes and monitoring tools with desktop procedures and applicable policies and procedures development. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Provides training, recommends process improvements, and mentors junior-level staff, department interns, etc. as needed. Performs other duties as assigned. Education Required
Bachelor's Degree in Accounting or Related Field In lieu of degree, equivalent education and/or experience may be considered. Experience Required
At least 3 years of experience in conducting financial audits. At least 5 years of related experience in the managed health care industry. Minimum of 2 years of accounting experience. Skills Required
Strong analytical and critical thinking skills. Action-oriented, self-starter, and excellent motivator. Excellent verbal and written communication skills. Able to prioritize assignments and able to work independently with minimal supervision. Ability to interface professionally with both internal and external customers at all levels of the organization. Proficiency in Microsoft Office (Excel, PowerPoint, and SharePoint). Licenses/Certifications
Must hold one of the following certifications:
Certified Public Accountant (CPA) Certified Management Accountant (CMA) Certified Internal Auditor (CIA) Certified Fraud Examiner (CFE) Contract Benefits
Medical, Vision, and Dental Insurance Plans 401k Retirement Fund About the Hiring Company
Not-for-profit healthcare organization focused on serving vulnerable and underserved communities in Los Angeles. Seeking entrepreneurial professionals with a passion for healthcare and business process improvement. Join our team and make a positive impact.
About GTT
GTT is a minority-owned staffing firm and a subsidiary of Chenega Corporation, a Native American-owned company in Alaska. As a Native American-owned, economically disadvantaged corporation, we highly value diverse and inclusive workplaces. Our clients are Fortune 500 banking, insurance, financial services, and technology companies, along with some of the nation’s largest life sciences, biotech, utility, and retail companies across the US and Canada. We look forward to helping you land your next great career opportunity! 25-23595 #gttjobs Seniority level
Seniority level Entry level Employment type
Employment type Contract Job function
Job function Accounting/Auditing and Finance Industries Staffing and Recruiting Referrals increase your chances of interviewing at Global Technical Talent, an Inc. 5000 Company by 2x Get notified about new Senior Auditor jobs in
Los Angeles, CA . Los Angeles, CA $50,000.00-$240,000.00 2 weeks ago Los Angeles, CA $90,000.00-$110,000.00 3 weeks ago Inglewood, CA $80,000.00-$95,000.00 1 month ago Los Angeles, CA $90,000.00-$100,000.00 3 weeks ago Culver City, CA $110,000.00-$120,000.00 3 days ago Monrovia, CA $100,743.00-$138,877.00 6 days ago Rosemead, CA $99,400.00-$149,100.00 6 days ago Senior Accountant, Financial Reporting and Technical Accounting
Commerce, CA $100,000.00-$130,000.00 3 hours ago Culver City, CA $60,200.00-$128,800.00 1 week ago Inglewood, CA $75,000.00-$85,000.00 2 months ago Los Angeles, CA $80,000.00-$110,000.00 13 hours ago Culver City, CA $60,200.00-$128,800.00 2 weeks ago Los Angeles, CA $70,000.00-$80,000.00 3 weeks ago Los Angeles, CA $100,000.00-$115,000.00 1 month ago Los Angeles, CA $80,000.00-$130,000.00 2 weeks ago Los Angeles, CA $80,000.00-$130,000.00 2 weeks ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr