Bright Vision Technologies · 3 hours ago
Senior Health Plan Auditor
CA
Full-time
Hybrid
Senior Level
5+ years expBright Vision Technologies is a forward-thinking software development company dedicated to building innovative solutions that help businesses automate and optimize their operations. The Senior Health Plan Auditor is responsible for planning, executing, reporting, and monitoring corrective action plans related to financial solvency and claims processing compliance for specialty health plans and vendors.
Artificial Intelligence (AI)Cyber SecurityInformation TechnologySoftware
Responsibilities
Perform financial audits and analyses for specialty health plans and vendors
Conduct claims processing audits to ensure regulatory and contractual compliance
Ensure timely and accurate audit deliverables related to financial solvency
Support quarterly and annual DMHC claims data submissions
Serve as liaison for CMS claim audits related to L.A. Care delegates
Monitor, track, and report corrective action plans and non-compliance notices
Assist in developing standardized audit workpapers and reporting templates
Maintain and annually update departmental Policies & Procedures (P&Ps)
Support legal, delegation oversight, and regulatory requests
Collaborate with internal departments, leadership, vendors, and plan partners
Identify opportunities for process improvement and technical solutions
Provide training, mentorship, and guidance to junior staff and interns
Participate in special projects and regulatory impact assessments
Qualification
Required
Bachelor's Degree in Accounting or a related field (required)
Minimum 3 years of experience conducting financial audits
Minimum 5 years of experience in the managed healthcare industry
At least 2 years of accounting experience
Strong analytical and critical-thinking skills
Excellent verbal and written communication abilities
Ability to work independently with minimal supervision
Strong organizational and prioritization skills
Professional communication with internal and external stakeholders
Proficiency in Microsoft Excel, PowerPoint, and SharePoint
Action-oriented, self-motivated, and detail-focused
Must have one of the following licenses/certifications: Certified Public Accountant (CPA), Certified Management Accountant (CMA), Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE)
Company
Bright Vision Technologies
Bright Vision Technologies is an information technology company that offers software development, AI, and cybersecurity services.
51-200 employees
H1B Sponsorship
Bright Vision Technologies has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (41)
2024 (14)
2023 (7)
2022 (12)
2021 (1)
Funding
Current Stage
Growth StageCompany data provided by crunchbase