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Financial Compliance Auditor III Finance

Job Category: Accounting/Finance

Department: Financial Compliance

Location:

Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 12177

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

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 a hybrid role and 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 role works closely with the Manager 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.

Serves as a subject matter expert,and mentor for other staff.

Duties

+ This position is 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.

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

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

+ Supports 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.

+ Serves as subject matter expert in assigned areas and cross training initiatives.

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

+ 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

Associate's Degree

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

Experience

Required:

At least 5 years of experience performing financial audits with the demonstrated experience on the following list of stated knowledge/experience:

Skills

Required:

+ Must be self-motivated.

+ Detail-oriented.

+ Excellent verbal and written communication skills.

+ Strong 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.

+ Preferred:

Healthcare experience

Financial audits

Financial analysis

Licenses/Certifications Required

Certified Public Accountant (CPA)

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.

+ Paid Time Off (PTO)

+ Tuition Reimbursement

+ Retirement Plans

+ Medical, Dental and Vision

+ Wellness Program

+ Volunteer Time Off (VTO)