IPA/Healthcare Provider Financial Compliance Auditor

*Position Summary/Position* Under the direction of the IPA Financial Compliance Manager, the Financial Compliance Auditor is responsible for conducting financial monitoring and oversight of IEHP’s delegated entities’ financial compliance.
This will include performing audits, identifying risks, reporting the results, and working with the IPAs to ensure they develop and implement an effective corrective action plan (CAP).
*Major Functions (Duties and Responsibilities)* 1.
Perform financial audits of contracted IPAs, medical groups, and/or delegated entities to verify solvency and good financial standing.
2.
Conduct exit interviews with delegated Providers to provide a preliminary overview of the audit results and to inform them of the next steps in the audit process.
3.
Draft financial audit reports of contracted IPAs, medical groups, and/or delegated entities summarizing audit results, findings, and/or required corrective action plans (CAPs).
4.
Follow-up and assist Providers with corrective action plans (CAPs) as needed to ensure compliance.
5.
Collaborate with the Claims Oversight Delegated team to share information from the financial audits and coordinate audit timing.
6.
Prepare quarterly financial viability reporting for all IPAs, medical groups, and/or delegated entities for the Delegation Oversight Committee.
7.
Monitor delegated entities’ compliance with maintaining sufficient and active LOCs when required by contract terms.
8.
Collaborate with IPAs to implement the Department of Health Care Services (DHCS) Medical Loss Ratio (MLR) reporting requirements.
9.
Participate in the data collection for the Rate Development Template (RDT).
10.
Promote teamwork and maintain effective working relationships with others throughout the organization.
11.
Demonstrate a commitment to incorporate LEAN principles into daily work.
*Supervisory Responsibilities* Leading: Self *Experience Qualifications* Minimum of two (2) years of experience in healthcare accounting/financial auditing.
*Education Qualifications* Bachelor’s degree in Accounting, Finance or related field from an accredited institution required.
*Drivers License Required* No *Knowledge Requirement* Knowledge of Generally Accepted Accounting Principles and Financial Audit Principles.
Solid understanding of DMHC, DHCS and CMS rules and regulations governing financial compliance.
*Skills Requirement* Strong analytical and problem-solving skills.
Excellent oral and written communication skills.
*Abilities Requirement* Ability to work independently or with little direction, strong initiative to meet established deadlines, and capable of building successful relationships across the organization.
*Commitment to Team Culture* The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture.
A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.
*Working Conditions* Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval.
All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.
*Work Model Location* Hybrid *Physical Requirements* Hearing: One-on-One - FREQUENTLY Near Visual Acuity - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: Traditional - FREQUENTLY Sitting - CONSTANTLY Indoors - FREQUENTLY Lighting - CONSTANTLY A reasonable salary expectation is between $61,422.
40 and $78,312.
00, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire.
We are also one of the largest employers in the region, designated as “Great Place to Work.
” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.
5 million members.
And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace.
As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come.
Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Job Type: Full-time Pay: $61,422.
40 - $78,312.
00 per year Benefits: * 401(k) * 401(k) matching * 457(b) * Dental insurance * Disability insurance * Flexible spending account * Health insurance * Health savings account * Life insurance * Paid time off * Tuition reimbursement * Vision insurance Physical setting: * Office Schedule: * 8 hour shift * Monday to Friday Ability to commute/relocate: * Rancho Cucamonga, CA 91730: Reliably commute or planning to relocate before starting work (Required) Education: * Bachelor's (Required) Experience: * Accounting: 2 years (Preferred) * Microsoft Excel: 2 years (Preferred) Work Location: Hybrid remote in Rancho Cucamonga, CA 91730