Compliance Auditor
Job DetailsJob LocationMain Office - Santa Barbara, CARemote TypeHybridPosition TypeFull TimeJob CategoryComplianceDescriptionSalary Range:
$60,592 - $90,889Job SummaryUnder the direction and supervision of the Audit Manager, and through collaboration with Directors and Management level staff, this position conducts audit activities of varying complexity and supports initiatives of moderate to complex difficulty related to the Compliance Audit Program.
This includes the performance of routine and complex audit and monitoring activities of internal health plan departments and external Plan delegates to ensure compliance with Medi-Cal and Medicare regulatory and contractual requirements, and operational plan requirements,as well as assisting in writing, reviewing, and coordinating corrective action plans.
Duties & Responsibilities Conducts routine and complex compliance audit activities, documenting results in audit work papers, developing detailed document request lists, conducting audit conferences and walk-throughs, and proposing recommendations for improvement.
Conducts audits of the Plan's delegates to ensure compliance with regulatory, contractual requirements, and HIPAA Privacy Standards.
Assists in developing risk assessments to identify compliance risks posed to the Plan.
Assists in the maintenance of CenCal Health's Compliance Risk Universe and Audit Plan.
Assists and supports the development, implementation, and maintenance of the Compliance Audit Program to ensure key performance indicators are met and compliance risks are proactively identified.
Conducts routine monitoring activities to ensure compliance with regulatory and contractual requirements.
Develop and maintain audit tools based on regulatory compliance with DHCS, DMHC, and CMS requirements.
Writes and reviews audit reports based on audit results and ensures accurate and quality of audit reporting.
Validates of effective implementation of corrective action plans (CAPs) from internal departments & delegates to ensure appropriate completion and make necessary recommendations as needed for compliance.
Creates reports and analyzes data for reporting to management, the Delegation Oversight Committee, Compliance Committee, and Governing Board.
Conducts regulatory research and provides an interpretation of regulations to ensure appropriate application.
Prepares and sends out Audit Announcement memos.
Prepare audit programs and conduct audits of assigned areas, including performing various audit procedures and documenting audit findings.
Perform and coordinate follow-up audits to determine if management has taken action to mitigate the risks identified.
Provide independent evaluations of operational controls, policies, and procedures.
Assists and supports the development of materials for audit Entrance and Exit conferences.
Other duties as assigned QualificationsKnowledge/Skills/AbilitiesRequired:
Excellent written and verbal communication skills with strong business writing aptitude; Strong organizational skills and attention to detail; Strong skills in problem identification, analysis, resolution, organization, and prioritization; Ability to reprioritize workload as needed; Ability to work productively with all Plan staff; Ability to coordinate work between departments; Ability to work with minimal supervision, both independently and in teams; Attention to detail and accuracy is a must for this position Audit experience Desired:
Understanding of basic principals of Medi-Cal and Knox-Keene regulatory requirements, managed health care, health care industry terminology Regulatory Auditing experience RN Certification desirable Education & Experience Two-Three (2-3) years' experience in the health care field with audit, quality assurance/quality improvement experience, or other highly regulated industry.
Experience in health care compliance preferred.
Must have experience researching, compiling, and organizing information from various sources.
Certified Internal Auditor (CIA), Certified Health Care Compliance (CHC), Certified Healthcare Auditor (CHA), CHIAP (Certified Healthcare Internal Audit Professional) preferred or ability to achieve certification within 1 year.
Recommended Skills Attention To Detail Auditing Business Correspondence Communication Content Management Corrective And Preventive Action (Capa) Estimated Salary: $20 to $28 per hour based on qualifications.
$60,592 - $90,889Job SummaryUnder the direction and supervision of the Audit Manager, and through collaboration with Directors and Management level staff, this position conducts audit activities of varying complexity and supports initiatives of moderate to complex difficulty related to the Compliance Audit Program.
This includes the performance of routine and complex audit and monitoring activities of internal health plan departments and external Plan delegates to ensure compliance with Medi-Cal and Medicare regulatory and contractual requirements, and operational plan requirements,as well as assisting in writing, reviewing, and coordinating corrective action plans.
Duties & Responsibilities Conducts routine and complex compliance audit activities, documenting results in audit work papers, developing detailed document request lists, conducting audit conferences and walk-throughs, and proposing recommendations for improvement.
Conducts audits of the Plan's delegates to ensure compliance with regulatory, contractual requirements, and HIPAA Privacy Standards.
Assists in developing risk assessments to identify compliance risks posed to the Plan.
Assists in the maintenance of CenCal Health's Compliance Risk Universe and Audit Plan.
Assists and supports the development, implementation, and maintenance of the Compliance Audit Program to ensure key performance indicators are met and compliance risks are proactively identified.
Conducts routine monitoring activities to ensure compliance with regulatory and contractual requirements.
Develop and maintain audit tools based on regulatory compliance with DHCS, DMHC, and CMS requirements.
Writes and reviews audit reports based on audit results and ensures accurate and quality of audit reporting.
Validates of effective implementation of corrective action plans (CAPs) from internal departments & delegates to ensure appropriate completion and make necessary recommendations as needed for compliance.
Creates reports and analyzes data for reporting to management, the Delegation Oversight Committee, Compliance Committee, and Governing Board.
Conducts regulatory research and provides an interpretation of regulations to ensure appropriate application.
Prepares and sends out Audit Announcement memos.
Prepare audit programs and conduct audits of assigned areas, including performing various audit procedures and documenting audit findings.
Perform and coordinate follow-up audits to determine if management has taken action to mitigate the risks identified.
Provide independent evaluations of operational controls, policies, and procedures.
Assists and supports the development of materials for audit Entrance and Exit conferences.
Other duties as assigned QualificationsKnowledge/Skills/AbilitiesRequired:
Excellent written and verbal communication skills with strong business writing aptitude; Strong organizational skills and attention to detail; Strong skills in problem identification, analysis, resolution, organization, and prioritization; Ability to reprioritize workload as needed; Ability to work productively with all Plan staff; Ability to coordinate work between departments; Ability to work with minimal supervision, both independently and in teams; Attention to detail and accuracy is a must for this position Audit experience Desired:
Understanding of basic principals of Medi-Cal and Knox-Keene regulatory requirements, managed health care, health care industry terminology Regulatory Auditing experience RN Certification desirable Education & Experience Two-Three (2-3) years' experience in the health care field with audit, quality assurance/quality improvement experience, or other highly regulated industry.
Experience in health care compliance preferred.
Must have experience researching, compiling, and organizing information from various sources.
Certified Internal Auditor (CIA), Certified Health Care Compliance (CHC), Certified Healthcare Auditor (CHA), CHIAP (Certified Healthcare Internal Audit Professional) preferred or ability to achieve certification within 1 year.
Recommended Skills Attention To Detail Auditing Business Correspondence Communication Content Management Corrective And Preventive Action (Capa) Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
