Financial Compliance Auditor III Job at Bright Vision Technologies (Los Angeles)

Job Description

The Specialty Health Plans Auditor III, Finance is responsible all aspects of 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 are intended to ensure that L.A. Care delegates are in compliance with applicable regulatory requirements and L.A. Care contractual agreements across all lines of business.

Job Responsibility

Performs financial audits and/or financial analyses for Specialty Health Plans on the quarterly and annual basis
Performs financial analyses for L.A. Care vendors on the quarterly and annual basis
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
Collaborates in the creation and implementation of standardized audit workpaper 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)
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 the 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 expertise in evaluating business operations and processes
Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed
Performs other duties as assigned

Requirements

Bachelors Degree in Accounting or Finance
At least 4 years of experience in conducting financial audits
At least 5 years of related experience in the managed health care industry
Excellent 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 independently with minimum 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)
Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) or Certified Fraud Examiner (CFE) or Certified Management Accountant (CMA)

Nice to have

Masters Degree
Health Care experience

What we offer

equal employment opportunities
inclusive work environment
accommodations during the recruitment process

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Financial Compliance Auditor III

Job Description

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