Inland Empire Health Plans
Rancho Cucamonga, CA, USA
Job Requisition ID: 7252
Position Summary/Position The Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program. The Compliance Audit III will oversee compliance auditing and monitoring initiatives to assess and identify compliance risks with Federal and State regulatory and contractual requirements. The Compliance Auditor IIIis responsible for conducting compliance audits, reporting results, identifying risks, establishing compliance monitoring processes, and assessing regulatory compliance of Health Plan operations.
Major Functions (Duties and Responsibilities) 1. Independently conducts complex audits 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.
2. Leads and reviews audits of the Plan’s delegates to ensure compliance with regulatory, contractual...