Financial Compliance Auditor III Finance

L.A. Care; Lancaster (CA); On-site; USD 89,000 - 142,000; Full time

Benefits offered by this job

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan in Los Angeles, CA is seeking a Financial Compliance Auditor III Finance to lead financial solvency reviews for plan partners, provider groups, and vendors, ensuring compliance with GAAP, DMHC, DHCS, CMS, and contract requirements.

The role collaborates with management and stakeholders to address findings, mentors staff, and develops reports and tools for corrective actions and regulatory monitoring across Medi-Cal, Covered California, and related programs.

Qualifications

• Bachelor's Degree in Finance or Accounting or related field.
• In lieu of degree, equivalent education and/or experience may be considered.
• Master's Degree preferred.
• At least 4 years of experience performing financial audits.
• Health care experience preferred.

Responsibilities

• Lead financial solvency reviews including planning, execution, monitoring, and reporting of audits.
• Deliver timely, accurate compliance deliverables for plan partners and vendors.
• Collaborate on special projects like Medical Loss Ratio.
• Develop reports and tools for corrective actions and non-compliance notices.
• Communicate findings to stakeholders concisely and timely.
• Mentor junior staff and collaborate across departments.

Skills

Self-motivated

Detail-oriented

Verbal and written communication

Analytical thinking

Prioritize assignments

Professional communication with StakeH

MS Office (Excel/PowerPoint/SharePoint

Travel flexibility

Education

Bachelor's degree in Finance or Accounting

Master's degree

Tools

Excel

PowerPoint

SharePoint

Job description

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

Financial Compliance Auditor III Finance

Job Category: Accounting/Finance

Location: Los Angeles, CA, US, 90017

Position Type: Full Time

Established 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.

Mission: 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.

Job Summary

The 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.

This 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.

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

Duties

Responsible 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.

Provides 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.

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

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

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

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

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

Responsible for the completion and monitoring of monthly membership report.

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

Communicates issues and findings in a concise and timely manner.

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

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

Bachelor's Degree in Finance or Accounting or Related Field

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

Education Preferred

Master's Degree

Experience

Required:

At least 4 years of experience performing financial audits.

Preferred:

Health Care experience.

Skills

Required:

Must be self-motivated.

Detail-oriented.

Excellent verbal and written communication skills.

Excellent analytical and critical thinking 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).

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

Licenses/Certifications Required

And/Or any of the following Licenses/ Certifications:

Certified Public Accountant (CPA)

Certified Internal Auditor (CIA)

Certified Medical Assistant (CMA)

Licenses/Certifications PreferredRequired TrainingPhysical Requirements

Light

Additional Information

Salary 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.

L.A. Care offersa wide range of benefits including

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program