L.A. Care Health Plan · 12 hours ago
Compliance Delegation Oversight Clinical Auditing and Monitoring Data Analyst III
1200 Building
Full-time
Onsite
Mid, Senior Level
$89K/yr - $142K/yr
4+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, created to provide health coverage to low-income residents of Los Angeles County. The Compliance Delegation Oversight Clinical Auditing and Monitoring Data Analyst III is responsible for supporting delegated clinical auditing and monitoring activities, ensuring compliance with regulatory requirements, and providing advanced data analysis and reporting.
FitnessGovernmentHealth Care
Responsibilities
Collect, validate, and analyze data related to all delegated clinical functions
Collaborate with auditors to ensure data integrity and completeness during pre-audit preparation, fieldwork, and post-audit validation
Maintain and monitor key performance indicators (KPIs) for delegated clinical functions in alignment with California Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), and Centers for Medicare and Medicaid Services (CMS) oversight expectations
Prepare datasets and summary reports for internal review, regulatory submissions, and executive dashboards
Maintain documentation and data repositories that demonstrate compliance with regulatory requirements for delegated oversight
Conduct root cause and trend analyses of audit results to identify patterns, systemic issues, or compliance risks among delegated entities
Maintain documentation and data repositories that demonstrate compliance with regulatory requirements for delegated oversight
Contribute to audit and monitoring policy and procedure updates, particularly those involving data validation and reporting protocols
Provide analytical support for strategic initiatives led by management
Apply subject matter expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training and recommend process improvements as needed
Performs other duties as assigned
Qualification
Required
Bachelor's Degree in Public Health or Related Field
At least 4 years of experience in data analysis in healthcare compliance, managed care operations, delegation oversight or clinical auditing
Experience maintaining, configuring, and optimizing audit management software or data tracking systems
Strong quantitative and qualitative analysis skills with the ability to interpret complex datasets and translate findings into actionable insights
Strong statistical and analytical skills, including multivariate analyses, regression, and control charts to identify drivers of operational, clinical, and financial performance
Knowledge of version control (Git, GitHub) and collaborative development workflows, including peer review, continuous integration, and reproducible analytic practices
Ability to develop and maintain reusable analytic frameworks, templates, and processes that support recurring reporting and performance monitoring
Proficiency in data validation, reconciliation, and adherence to governance standards, including data lineage tracking and quality control
Working knowledge of DHCS, DMHC, and CMS oversight requirements for clinical delegation and managed care operations
Knowledge of SQL queries, relational databases, and system integration concepts. Advanced proficiency in tools such as Power BI, Tableau, or Smartsheet for building dashboards and visual reports
Excellent written and verbal communication skills with the ability to quickly gather, summarize, and meaningfully communicate dense, complex content clearly to all levels of the L.A. Care organization, and external regulating bodies
Strong elicitation and process documentation skills
Ability to respond resourcefully to change and ambiguity, generates and champions ideas and initiatives, and thoughtfully identifies the connections within the organization to effectively integrate efforts across units and functions
Ability to translate complex business problems into structured analytic requirements and actionable insights
Ability to interpret analytic results in the context of organizational performance, operational priorities, and enterprise goals
Ability to apply critical thinking to identify patterns, opportunities, and risks across multiple data domains
Ability to collaborate effectively with cross-functional stakeholders to operationalize analytic outputs
Demonstrated knowledge of healthcare concepts, such as quality measures, utilization patterns, and key operational drivers in a managed care environment
Ability to lead analytic projects end-to-end, including business case definition, requirements gathering, analysis, and post-implementation assessment
Ability to manage multiple projects simultaneously, prioritize tasks, and escalate issues appropriately
Preferred
Master's Degree
Strong knowledge of Governance, Risk and Compliance (GRC) Systems, Tableau, Visio
Certified HealthCare Compliance (CHC)
Certified in Healthcare Compliance Fellow (CHC-F)
Certified Compliance & Ethics Professional (CCEP)
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
2026-01-17
MarketScreener
2025-08-27
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