Financial Compliance Auditor III Finance

Job description

Financial Compliance Auditor III Finance

nJob Category: Accounting/Finance

nDepartment: Financial Compliance

nLocation:

nLos Angeles, CA, US, 90017

nPosition Type: Full Time

nRequisition ID: 13319

nSalary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)

nEstablished 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, we make sure our members get the right care at the right place at the right time.

nMission: L.A. Care’s 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.

nJob Summary

nThe Financial Compliance Auditor III Finance is responsible for various tasks within the Financial Compliance Unit which include, but not limited to, performing, reporting, and corrective action plan monitoring of financial solvency reviews of plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors contracted with L.A. Care. This position is responsible for the overall financial solvency compliance on-going monitoring of assigned delegates across all lines of business including Medi-Cal, Covered California, D-SNP, and PASC-SEIU.

nThis position works closely with management and other team members on the identification and resolution of issues in a timely and efficient manner. This position leads assigned audits independently in accordance with general accepted auditing standards, generally accepted accounting principles (GAAP), regulations of the Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and other federal and state guidelines. Responsible for the on-going communication, collaboration, and issue resolution on financial solvency issues with interdepartmental personnel, key stakeholders, and delegates.

nActs as a Subject Matter Expert, serves as a resource and mentor for other staff.

nDuties

nResponsible for all aspects of financial solvency reviews including, but not limited to, the planning, execution, continuous monitoring, and reporting of annual financial audits, quarterly and annual financial analyses (ratio and trending analyses), and special projects.

nProvides 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.

nCollaborates the design, implementation, and reporting of special projects such as Medical Loss Ratio.

nCollaborates the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications.

nCollaborates the assessment, communication, implementation of regulatory requirements that may impact internal processes.

nSupports the formalization of key internal processes and monitoring tools with desktop procedures and applicable policies and procedures development.

nResponsible for the financial audit team’s pre-delegation reviews and delivers monthly/quarterly request updates to various business units.

nDuties Continued

nResponsible for the completion and monitoring of monthly membership report.

nAccountable for the completion of requests from Legal Department, Delegation Oversight’s monitoring oversight and reporting.

nCommunicates issues and findings in a concise and timely manner.

nResponsible for the overall communication and collaboration with interdepartmental personnel, leadership, and delegates.

nApplies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.

nPerforms other duties as assigned.

nEducation Required

nBachelor's Degree in Finance or Accounting or Related Field

nIn lieu of degree, equivalent education and/or experience may be considered.

nEducation Preferred

nMaster's Degree

nExperience

nRequired:

nAt least 4 years of experience performing financial audits.

nPreferred:

nHealth Care experience.

nSkills

nRequired:

nMust be self-motivated.

nDetail-oriented.

nExcellent verbal and written communication skills.

nExcellent analytical and critical thinking skills.

nAble to prioritize assignments, and able to independently with minimum supervision.

nAbility to interface professionally with both internal and external customers at all levels of the organization.

nProficiency in Microsoft Office (Excel, PowerPoint, and SharePoint).

nMust also have flexible mode of transportation for considerable amount of travel to work off-site.

nLicenses/Certifications Required

nAnd/Or any of the following Licenses/ Certifications:

nCertified Public Accountant (CPA)

nCertified Internal Auditor (CIA)

nCertified Medical Assistant (CMA)

nCertified Fraud Examiner (CFE)

nLicenses/Certifications Preferred

nRequired Training

nPhysical Requirements

nLight

nAdditional Information

nSalary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

nL.A. Care offers a wide range of benefits including

nnnPaid Time Off (PTO)

n

nnTuition Reimbursement

n

nnRetirement Plans

n

nnMedical, Dental and Vision

n

nnWellness Program

n

nnVolunteer Time Off (VTO)

n

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Worksite address

los angeles, CA, 90079, US

Who can apply

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