Job posting has expired
Compliance Audit Program Manager
Santa Clara County Health Plan | |
United States, California, San Jose | |
6201 San Ignacio Avenue (Show on map) | |
Jul 22, 2024 | |
Compliance Audit Program Manager
Salary Range: $107,930 - $167,292 FLSA Status: Exempt GENERAL DESCRIPTION OF POSITION The Compliance Audit Program Manager is responsible for coordinating plan-wide auditing activities, including audits of the Plan's internal business units and First Tier, Downstream and Related entities (FDRs). The incumbent participates in the development of risk assessment tools and in conducting risk assessments for business units and FDRs, and develops a comprehensive audit plan tailored to address the relative risks presented by each business unit and FDR. The Compliance Audit Program Manager also develops compliance audit protocols, manages and conducts audits, drafts and presents audit reports and manages the corrective audit process to ensure proper remediation of deficiencies identified in audits. ESSENTIAL DUTIES AND RESPONSIBILITIES To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.
REQUIREMENTS - Required (R) Desired (D) The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.
2. Minimum two years auditing experience, preferably in a managed care or health care environment. (R) 3. Demonstrated current working knowledge of audit theories, standards, and techniques. (R) 4. Experience in managed care or in a health care setting requiring routine interaction with internal and external stakeholders. (R) 5. Experience with Medi-Cal or Medicare programs. (D) 6. Ability to gather and analyze data, organize and write reports and organize work efficiently. (R) 7. Strong project management skills. (R) 8. Ability to develop an advanced level of knowledge of those portions of the laws and regulations relevant to CMS, DMHC, DHCS. (R) 9. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) 10. Working knowledge and the ability to efficiently operate all applicable computer software including a working knowledge of computer applications such as Outlook, Word, Excel and PowerPoint. Ability to learn how to expertly use the Health Plan's core database software. (R) 11. Ability to use a keyboard with moderate speed and a high level of accuracy. (R) 12. Excellent communications skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments and outside entities over the telephone, in person or in writing. (R) 13. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R) 14. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R) 15. Ability to maintain confidentiality. (R) 16. Ability to comply with all SCFHP policies and procedures. (R) 17. Ability to perform the job safely with respect to others, to property, and to individual safety. (R) PHYSICAL REQUIREMENTS
ENVIRONMENTAL CONDITIONS EOE |