L.A. Care Health Plan · 5 months ago
Manager, Financial Compliance Audit
Los Angeles, CA
Full-time
Onsite
Mid, Senior Level
$118K/yr - $188K/yr
6+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, dedicated to providing health coverage to low-income communities in Los Angeles County. The Manager, Financial Compliance Audit is responsible for overseeing the financial audit team, ensuring compliance with contractual agreements and regulations, and managing financial solvency audits for various healthcare delegates. This role involves collaboration with cross-functional teams to address audit issues and improve operational efficiency.
FitnessGovernmentHealth Care
Responsibilities
Manage staff, including, but not limited to monitoring of staff performance, mentoring, training, and cross training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others
Develop goals, objectives and actions plans for assigned staff, which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees
Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval
Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities
Monitor and analyze membership data by delegate on a monthly basis to assign the annual claim processing and financial solvency audits, adherence to regulatory requirements
Manage complex financial solvency audits to ensure quality deliverables, resolve audit issues, and issuance of final audit reports. Request and follow-up on Corrective Action Plans (CAPs) on non-compliant audit results
Develop, implement and execute the audit program and audit procedures for updates and/or changes in the agreement and applicable regulations
Oversee the comprehensive financial analysis on a quarterly and annual basis to ensure Plan Partner (PPs), Participating Physician Groups (PPGs), and capitated hospitals comply with the financial solvency requirements. Request and follow-up on CAP for non-compliant issues
Monitor the plan partners' audit and quarterly financial analysis of their Medi-cal provider network
Provide data and information to other business units and management as need
Communicate effectively with Director of Financial Compliance regarding compliance matters from audits or quarterly financial statements analysis including recommendations and corrective action plans requirements
Maintain related company's policies and procedures ensuring they are remain current
Proactively identify opportunities to improve the effectiveness and efficiency of the financial audit function
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Finance or Accounting or Related Field
At least 6 years of experience in financial auditing in a managed care industry
At least 4 years of leading staff or supervisory/management experience
Must be able to handle the growing population in the L.A. Care network and audit activities
Excellent verbal and written communication skills
Proven experience in leading and managing audit teams
Significant experience in assessing, investigating, and auditing compliance risks
Knowledge of relevant managed care regulations and audit methodologies
Excellent analytical and problem-solving skills
Ability to interface professionally with both internal and external customers at all levels of the organization
Must be self-motivated, detail-oriented, prioritize assignments, and able to work as part of a team
Knowledge of and ability to oversee the major responsibilities, accountabilities, and organization of the audit and compliance function
Knowledge of and ability to create, implement, evaluate and enhance internal control processes
Preferred
Master's Degree
Certified Public Accountant (CPA)
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
MarketScreener
2025-08-27
2025-08-04
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