Financial Compliance Auditor III, Finance
We leverage cutting-edge technologies to create scalable, secure, and user-friendly applications. As we continue to grow, we’re looking for a skilled Financial Compliance Auditor III, Finance to join our dynamic team and contribute to our mission of transforming business processes through technology. This is a fantastic opportunity to join an established and well-respected organization offering tremendous career growth potential. Position: Financial Compliance Auditor III, Finance
Location: Los Angeles, CA 90017
Duration: Contract
Job Summary
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. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.
Essential Duties and Responsibilities
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). 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 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. 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.
Performs other duties as assigned. Education Required: Bachelors Degree in Field of Study I: Accounting /Field of Study 2: Finance Preferred: Masters Degree Equivalent: In lieu of degree, equivalent education and/or experience may be considered. 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. Preferred: Health Care experience. 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 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). Professional License/ Certification Required:
Certified Public Accountant (CPA) or
Certified Internal Auditor (CIA) or
Certified Fraud Examiner (CFE) or
Certified Management Accountant (CMA) Would you like to know more about this opportunity? For immediate consideration, please send your resume directly to ayushi @bvteck.com or contact us via phone at (908) 650-6382 | ext 1009
At BVTeck, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know.
Equal Employment Opportunity (EEO) Statement
Bright Vision Technologies (BV Teck) is committed to equal employment opportunity (EEO) for all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, veteran status, or any other protected status as defined by applicable federal, state, or local laws. This commitment extends to all aspects of employment, including recruitment, hiring, training, compensation, promotion, transfer, leaves of absence, termination, layoffs, and recall.
BV Teck expressly prohibits any form of workplace harassment or discrimination. Any improper interference with employees' ability to perform their job duties may result in disciplinary action up to and including termination of employment.
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