Claims Delegation Audit Leader

Astrana Health Management; Monterey Park (CA); Hybrid; USD 78,000 - 91,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Astrana Health seeks a Supervisor – Claims Delegation Oversight to lead external audit programs and oversee audits with health plans and regulators. You will drive strategy, CAP management, and process improvements across Claims Ops, partnering with IT and Analytics to optimize scorecards and reporting.

The role requires strong regulatory knowledge, leadership, and cross-functional collaboration in a hybrid office environment at 1600 Corporate Center Dr., Monterey Park, CA.

Qualifications

• 3+ years of claims administration experience in a Health Plan/IPA/MSO setting.
• Proficiency in Excel for reporting and analysis.
• Experience with health plan audits and delegation oversight is preferred.

Responsibilities

• Lead external audits planning, execution and support across health plans and regulators.
• Oversee end-to-end audit lifecycle and CAP management.
• Develop metrics and dashboards to track audit performance.
• Collaborate with Claims Ops, IT/Data Analytics to improve scorecards and reports.
• Mentor and lead the team to achieve audit excellence.

Skills

Leadership

Audit management

Regulatory knowledge

Root cause analysis

Cross-functional collaboration

Analytical thinking

Project management

Communication

Education

BS/BA or equivalent

Tools

Excel

Job description

Astrana Health seeks a Supervisor – Claims Delegation Oversight to lead external audit programs and oversee audits with health plans and regulators. You will drive strategy, CAP management, and process improvements across Claims Ops, partnering with IT and Analytics to optimize scorecards and reporting.

The role requires strong regulatory knowledge, leadership, and cross-functional collaboration in a hybrid office environment at 1600 Corporate Center Dr., Monterey Park, CA.