We have other current jobs related to this field that you can find below

  • Compliance Auditor III

    2 months ago

    Rancho Cucamonga, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program. The Compliance Audit III will oversee...

  • Compliance Auditor III

    3 months ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program. The Compliance Audit III will oversee...

  • Compliance Auditor III

    1 month ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program. The Compliance Audit III will oversee...

  • Auditor III

    2 months ago

    Rancho Cucamonga, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Internal Controls Manager, the Internal Controls Auditor III is responsible for conducting internal audits and reporting results...

  • Auditor III

    4 days ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!Under the direction of the Internal Controls Manager, the Internal Controls Auditor III is responsible for conducting internal audits and reporting results identifying...

  • Auditor III

    1 week ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    What you can expect!Be one of the first applicants, read the complete overview of the role below, then send your application for consideration.Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Under the direction of the Internal...

  • Financial Compliance Auditor

    1 month ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of the IPA Financial Compliance Manager, the Financial Compliance Auditor is responsible for conducting financial monitoring and...

  • Analyst III

    1 month ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! The Analyst III Compliance Program has expert knowledge and performs key Compliance Program activities of complex difficulty. Team Members in this position...

  • Healthcare Compliance Analyst

    6 days ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Position Overview:What You Can Anticipate:Join the Inland Empire Health Plan (IEHP) team, where we are dedicated to uplifting and supporting the well-being of our community. Transition from a mere job opportunity to a meaningful career that makes a difference.In this role, the Healthcare Compliance Analyst will operate under general supervision to conduct...

  • Compliance Technical Analyst II

    1 month ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! The Compliance Technical Analyst II is responsible for managing and supporting the development, implementation, and maintenance of compliance systems,...

  • Accountant III

    1 month ago

    Rancho Cordova, United States AMPAC Fine Chemicals Full time

    Job DescriptionJob DescriptionThe Accountant III ensures accurate financial reporting by preparing and analyzing transactions, journal entries, and reports. Key duties include account reconciliations, variance analysis, managing invoicing and collections, and overseeing cash receipts. The role involves creating financial tools, enhancing accounting methods,...

  • Internal Audit Clerk

    4 weeks ago

    Rancho Cucamonga, United States SUMITOMO RUBBER NORTH AMERICA INC Full time

    We are seeking a dynamic and motivated Internal Auditor to join our team! In this exciting role, you will have the opportunity to apply your expertise in auditing concepts, practices, and procedures to conduct thorough audits of various company processes across diverse departments and locations. Your responsibilities will include verifying reports against...

  • Internal Audit Clerk

    4 weeks ago

    Rancho Cucamonga, California, United States SUMITOMO RUBBER NORTH AMERICA INC Full time

    We are seeking a dynamic and motivated Internal Auditor to join our team In this exciting role, you will have the opportunity to apply your expertise in auditing concepts, practices, and procedures to conduct thorough audits of various company processes across diverse departments and locations. Your responsibilities will include verifying reports against...

  • Accounting Compliance Analyst

    5 days ago

    Rancho Cordova, California, United States Bank of Marin Full time

    Position Overview:Bank of Marin, recognized as one of the premier workplaces in the North Bay Business Journal, is in search of a Regulatory Financial Analyst. This role is pivotal in supporting various aspects of SEC and regulatory reporting at our esteemed institution.Key Responsibilities:Prepare and review quarterly financial disclosures for stakeholders,...

  • Food Safety Quality Auditor

    5 hours ago

    Rio Rancho, New Mexico, United States LHH Recruitment Solutions Full time

    Job OverviewPosition: Food Safety Quality Auditor – Food Production SectorLHH Recruitment Solutions is seeking a dedicated Food Safety Quality Auditor to enhance our client's operations. This pivotal role is essential in upholding stringent food safety protocols, regulatory compliance, and quality benchmarks. The selected candidate will collaborate with...

  • Human Resources Director

    5 days ago

    Rancho Cucamonga, United States Adriana's Insurance Services Full time

    As the HR Director for our insurance brokerage, you will be a strategic leader responsible for overseeing all human resources functions, with a strong emphasis on ensuring compliance with regulatory requirements and industry standards. You will develop and implement HR policies and procedures that promote a positive work environment while proactively...

  • Human Resources Director

    4 days ago

    Rancho Cucamonga, United States Adriana's Insurance Services Full time

    As the HR Director for our insurance brokerage, you will be a strategic leader responsible for overseeing all human resources functions, with a strong emphasis on ensuring compliance with regulatory requirements and industry standards. You will develop and implement HR policies and procedures that promote a positive work environment while proactively...

  • Night Auditor

    2 months ago

    Rio Rancho, United States Extended Stay Rio Rancho Full time

    Job Summary: The Night Auditor is responsible for the preparation and disposition of all Night Audit work. Responsible for the front desk operation during the overnight shift (Typically 11pm-7am). Primary responsibilities include: registering guests making reservations preparing daily reports balancing transactions and conducting security walks....

  • Clinical Operations Supervisor

    8 hours ago

    Rancho Cucamonga, California, United States South Coast Children's Society Full time

    Job OverviewPOSITION SUMMARY:The Clinical Operations Supervisor is tasked with managing the daily clinical functions of the program. This position requires active participation in Child and Family Team meetings, offering clinical guidance, and ensuring adherence to all regulatory requirements. The Supervisor also works closely with county auditors and...

  • Clinical Operations Supervisor

    5 hours ago

    Rancho Cucamonga, California, United States South Coast Children's Society Full time

    Job OverviewPOSITION SUMMARY:The Clinical Operations Supervisor plays a crucial role in managing the daily clinical functions of the program. This position requires active participation in Child and Family Team meetings, offering clinical guidance, and ensuring adherence to all regulatory requirements. The Supervisor also works closely with county auditors...

Compliance Auditor III

2 months ago

Rancho Cucamonga, United States IEHP Full time

What you can expect

Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience


Job Summary


The Compliance Auditor III is responsible to lead and conduct key activities of the IEHP Compliance Audit Program. The Compliance Audit III will oversee compliance auditing and monitoring initiatives to assess and identify compliance risks with Federal and State regulatory and contractual requirements. The Compliance Auditor III is responsible for conducting compliance audits, reporting results, identifying risks, establishing compliance monitoring processes, and assessing regulatory compliance of Health Plan operations.


Key Responsibilities:

1. Independently conducts complex audits and monitoring activities of internal health plan departments and external Plan delegates to ensure compliance with Medi-Cal and Medicare regulatory and contractual requirements, and operational plan requirements.

2. Leads and reviews audits of the Plan’s delegates to ensure compliance with regulatory, contractual requirements, and HIPAA Privacy Standards.

3. Contributes the development, implementation, and maintenance of the Compliance Audit Program to ensure key performance indicators are met and compliance risks are proactively identified.

4. Contributes to and supports comprehensive risk assessments, provides recommendations on how risks may be addressed, develops IEHP’s Compliance Risk Universe, Heat Map, and maintains the Compliance Risk Register and Audit Plan.


Education & Experience

  • Bachelor’s degree in a related field from an accredited institution required.
  • Minimum of six (6) years in a managed care operations, working with one or more of the following areas: Utilization Management, Claims, Pharmacy Operations, Compliance, FDR oversight activities, Quality Management, Care Management, and/or Grievances and Appeals. Demonstrated experience, at a professional level, in an audit role and in supporting compliance audit program initiatives.
  • Experience conducting compliance audits of internal health plan operations and delegated entities.
  • Three (3) years of experience in leading audits.
  • Advanced knowledge of regulatory research and regulations that apply to Medi-Cal and Medicare Managed Care Health Plans.


Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.