L.A. Care Health Plan
Specialty Health Plans Auditor III Finance *$5,000 SIGN ON BONUS
L.A. Care Health Plan, Los Angeles, California, United States, 90079
Overview
Specialty Health Plans Auditor III Finance
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$5,000 SIGN ON BONUS Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12451 Salary Range:
$88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members. Our mission is to provide access to quality health care for Los Angeles County’s vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Role purpose:
The Specialty Health Plans Auditor III Finance role with a Sign-on Bonus of $5,000 is responsible for planning, execution, reporting, and corrective action plans monitoring of financial solvency for specialty health plans and vendors. This includes medical, vision, dental, behavioral health, transportation, and telehealth services providers. These audits ensure that L.A. Care delegates comply with regulatory requirements and L.A. Care contractual agreements across all lines of business. Acts as a Subject Matter Expert and a resource/mentor for other staff. Duties
Performs financial audits and/or financial analyses for Specialty Health Plans on a quarterly and annual basis. Performs financial analyses for L.A. Care vendors on a quarterly and annual basis. Provides timely and accurate deliverables to ensure financial solvency compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors. Collaborates in the creation and implementation of standardized audit workpapers and reporting templates. Is cross trained on financial solvency reviews for Participating Physician Group (PPGs), PPs, and capitated hospitals. Reviews and updates annually 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. Supports the formalization of key internal processes and monitoring tools. Accountable for the completion of requests from Legal Department, Delegation Oversight’s monitoring oversight and reporting. Responsible for overall communication and collaboration with interdepartmental personnel, leadership, specialty health plans, and vendors. Collaborates on the design, implementation, and reporting of special projects. Collaborates on the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications. Collaborates on the assessment, communication, and implementation of regulatory requirements that may impact internal processes. Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Provides mentorship and ensures accuracy of project deliverables to meet department, organizational, and regulatory needs. Provides training and recommends process improvements as needed and mentors junior staff and interns. Performs other duties as assigned. Education
Education Required:
Bachelor\'s Degree in Finance or Accounting or Related Field. In lieu of degree, equivalent education and/or experience may be considered. Education Preferred:
Master\'s Degree Experience
Required:
At least 4 years of experience in conducting financial audits. At least 5 years of related experience in the managed health care industry. Skills
Required:
Excellent analytical and critical thinking skills. Action-oriented, self-starter, and excellent motivator. Excellent verbal and written communication skills. Able to prioritize assignments and 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). Salary Range Disclaimer:
The expected pay range is based on factors such as geography, experience, education, and market conditions, and is subject to change. Benefits
Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program
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Specialty Health Plans Auditor III Finance
–
$5,000 SIGN ON BONUS Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12451 Salary Range:
$88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members. Our mission is to provide access to quality health care for Los Angeles County’s vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Role purpose:
The Specialty Health Plans Auditor III Finance role with a Sign-on Bonus of $5,000 is responsible for planning, execution, reporting, and corrective action plans monitoring of financial solvency for specialty health plans and vendors. This includes medical, vision, dental, behavioral health, transportation, and telehealth services providers. These audits ensure that L.A. Care delegates comply with regulatory requirements and L.A. Care contractual agreements across all lines of business. Acts as a Subject Matter Expert and a resource/mentor for other staff. Duties
Performs financial audits and/or financial analyses for Specialty Health Plans on a quarterly and annual basis. Performs financial analyses for L.A. Care vendors on a quarterly and annual basis. Provides timely and accurate deliverables to ensure financial solvency compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors. Collaborates in the creation and implementation of standardized audit workpapers and reporting templates. Is cross trained on financial solvency reviews for Participating Physician Group (PPGs), PPs, and capitated hospitals. Reviews and updates annually 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. Supports the formalization of key internal processes and monitoring tools. Accountable for the completion of requests from Legal Department, Delegation Oversight’s monitoring oversight and reporting. Responsible for overall communication and collaboration with interdepartmental personnel, leadership, specialty health plans, and vendors. Collaborates on the design, implementation, and reporting of special projects. Collaborates on the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications. Collaborates on the assessment, communication, and implementation of regulatory requirements that may impact internal processes. Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Provides mentorship and ensures accuracy of project deliverables to meet department, organizational, and regulatory needs. Provides training and recommends process improvements as needed and mentors junior staff and interns. Performs other duties as assigned. Education
Education Required:
Bachelor\'s Degree in Finance or Accounting or Related Field. In lieu of degree, equivalent education and/or experience may be considered. Education Preferred:
Master\'s Degree Experience
Required:
At least 4 years of experience in conducting financial audits. At least 5 years of related experience in the managed health care industry. Skills
Required:
Excellent analytical and critical thinking skills. Action-oriented, self-starter, and excellent motivator. Excellent verbal and written communication skills. Able to prioritize assignments and 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). Salary Range Disclaimer:
The expected pay range is based on factors such as geography, experience, education, and market conditions, and is subject to change. Benefits
Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program
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