Director of Operational Audit & Process Improvement

Astrana Health, Inc.; Alhambra (CA); Hybrid; USD 180,000 - 200,000; Full time

Job summary

Astrana Health is seeking a Director of Internal Audit Operations in Alhambra, CA to design and run the operational audit program across claims, credentialing, revenue cycle, and vendor oversight. You will lead end-to-end engagements, test processes, and validate improvements that drive measurable benefits for patients and health plans.

Reporting to the Audit Committee and Chief Accounting Officer, you will mentor staff, partner with Finance and Compliance, and ensure timely, actionable findings

Qualifications

• Bachelor's degree in Accounting, Finance, Business, Healthcare Administration, or related field.
• 10+ years of internal audit, operational audit, compliance auditing, or process improvement experience.
• Healthcare experience in a health plan, IPA, MSO, provider organization, or healthcare advisory.
• Strong analytical skills and ability to work independently with large datasets.
• Excellent written and verbal communication; experience presenting to executives.

Responsibilities

• Build and maintain a risk-based operational audit plan covering multiple healthcare processes.
• Lead end-to-end operational audits: scoping, walkthroughs, testing, and reporting.
• Test core processes: claims adjudication, credentialing, revenue cycle, and data governance.
• Audit risk adjustment operations, including chart review and data validation.
• Assess governance, delegated oversight, and regulatory compliance with CMS, DMHC, DHCS.
• Use data analytics on full populations and construct repeatable tests.
• Present results to the Audit Committee and executive leadership; drive remediation.
• Mentor audit staff; align with Finance and SOX for integrated coverage.

Skills

Analytical skills

Communication skills

Ability to quantify impact

Education

Bachelor's degree in Accounting, Finance, Business, Healthcare Administration, or related field

Tools

SQL

Power BI

Tableau

Job description

Astrana Health is seeking a Director of Internal Audit Operations in Alhambra, CA to design and run the operational audit program across claims, credentialing, revenue cycle, and vendor oversight. You will lead end-to-end engagements, test processes, and validate improvements that drive measurable benefits for patients and health plans.

Reporting to the Audit Committee and Chief Accounting Officer, you will mentor staff, partner with Finance and Compliance, and ensure timely, actionable findings