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Join to apply for the Specialty Health Plans Auditor III role at L.A. Care Health Plan

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Salary Range: $88,854 (Min.) - $115,508 (Mid.) - $142,164(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 Specialty Health Plans Auditor III is responsible for all aspects of planning, execution, reporting, and corrective action plans, monitoring of financial solvency, and claims processing compliance for specialty health plans and vendors. These audits are intended to ensure that L.A. Care delegates comply with regulatory requirements and L.A. Care contractual agreements across all lines of business.

The position is responsible for the Department of Managed Health Care (DMHC) claims data submissions for L.A. Care and its Plan Partners (PPs) and tasks are delegated each quarter and annually. Primarily responsible for the creation, review, and submission of departmental policies and procedures annually.

Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.

Duties

Performs financial audits and/or financial analyses for Specialty Health Plans on a quarterly and annual basis

Perform

📌 Senior Health Plan Auditor III (Lima)
🏢 L.A. Care Health Plan
📍 Lima