Senior Compliance Auditor: Health Plan Risk & Quality

Inland Empire Health Plans; Rancho Cucamonga (CA); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive salary

On-site fitness center

Medical insurance

Life and disability insurance

Professional development

Wellness programs

Flexible Spending Account

CalPERS retirement

457(b) plan

Pet care insurance

Job summary

Inland Empire Health Plans is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contractual requirements. You will identify risks, draft findings, and recommend improvements to strengthen the control environment.

The role involves evaluating operations and policies, issuing corrective action plans, and monitoring implementation while aligning with IEHP's quality initiatives like HEDIS, CAHPS, and NCQA Accreditation.

Qualifications

• Bachelor’s degree required; four years of related experience acceptable in lieu of degree.
• Experience interpreting California managed care regulations and audit responsibilities.
• CIA/CHC/CHA/CHIAP certifications are preferred but not mandatory.

Responsibilities

• Plan and conduct comprehensive audits across the Plan and delegates to ensure regulatory compliance.
• Identify risks, draft findings, and provide actionable recommendations to strengthen controls.
• Evaluate operations, policies, and processes; develop corrective action plans and monitor progress.
• Participate in special reviews and validate effectiveness of corrective actions.

Skills

Audit standards knowledge

Regulatory knowledge

Communication skills

Problem solving

Team collaboration

MS Excel proficient

Education

Bachelor’s degree from an accredited institution

Four years of additional relevant work experience in lieu of degree

Certified Internal Auditor (CIA) / CHC / CHA / CHIAP preferred

Tools

Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

Job description

Inland Empire Health Plans is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contractual requirements. You will identify risks, draft findings, and recommend improvements to strengthen the control environment.

The role involves evaluating operations and policies, issuing corrective action plans, and monitoring implementation while aligning with IEHP's quality initiatives like HEDIS, CAHPS, and NCQA Accreditation.