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<p><b>Salary Range:&nbsp;</b>&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Delegation Oversight Compliance Auditor III is responsible for planning, coordination, and conducting comprehensive compliance audits and reviews to assess adherence to regulatory requirements, contractual obligations, and internal policies for L.A. Care subcontracted providers.&nbsp; Additionally, the Auditor III will provide updates and recommendations to Management on quality and delegation oversight responsibilities, participate in fraud, waste, and abuse investigations as applicable, and oversee pre-delegation and annual audits for new and existing delegated entities to drive continuous improvement and adherence to regulatory standards by ensuring delegates are compliant with regulatory requirements. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.</p><p><b>Regulatory:</b></p><p>Researches, analyzes, and interprets contractual, state, and federal regulatory, and accreditation requirements. Stays abreast of changes in healthcare regulations, laws, and industry standards; analyzes regulatory developments and assesses their impact on the organization. Updates existing audit tools and creates audit tools based on the regulatory requirements. Assists management team with informing team of regulatory changes to ensure alignment with regulatory requirements and industry best practices.</p><p><b>Audit:</b></p><p>Plans, coordinates, and conduct with other auditors and conducts comprehensive compliance audits and reviews to assess adherence to regulatory requirements, contractual obligations, and internal policies for L.A. Care subcontracted providers including, but not limited to, Participating Physician Groups, Plan Partners, and Specialty Health Plans/Vendors. Independently conducts complex audits, including scoping, research, tool development, field work, reporting, and corrective action plan validation. Identifies, documents, and trends audit issues and provides appropriate coaching and shares best practices with delegated entities to assist with performance improvement. </p><p><b>Investigate and Risk Assessment:</b></p><p>Investigates and escalates allegations of non-compliance, fraud, or misconduct; develops and implements corrective action plans to address identified issues and prevent recurrence. Conducts risk assessments to identify compliance risks and develops strategies to mitigate risks and strengthens internal controls. Alerts management of identified new or emerging compliance risks and makes recommendations on DOA’s audit plan or monitoring plan to other business unit. Serves as a subject matter expert in compliance auditing, risk assessment, risk mitigation planning and regulatory interpretation and application. </p><h4>Duties Continued</h4><p><b>Collaboration:</b></p><p>Leads entrance calls, exit conferences, and technical calls with delegates. Collaborates with cross-functional teams, including but not limited to Legal, Compliance, Quality Assurance to address compliance-related challenges and delegate’s performance deficiencies, and implement effective solutions. Assists management to establish processes to track program effectiveness; monitor and analyze data to identify trends and areas for improvement. Works closely with Delegation Oversight Audit management on and to co-lead projects.</p><p><b>Reports:</b></p><p>Prepares and presents comprehensive reports and presentations to senior leadership, internal Committees, external entities, summarizing compliance activities, findings, and recommendations. Reviews and provides feedback on work papers of other Auditors to ensure accurate testing, results, and reports, and to ensure adherence to departmental procedures and protocols.</p><p><b>Training:</b></p><p>Develops and delivers compliance training programs for internal staff members, such as Delegation Oversight Audit team, and other business units within L.A. Care. In addition, to develop training programs for delegates as external entities ensuring awareness of compliance requirements and promoting a culture of compliance throughout the organization and with delegates. Leads and manages compliance projects and initiatives, auditors’ trainings. Develops training materials, updates audit tools, performs risk assessments, policy development, and process improvement efforts. </p><p>Perform other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Healthcare Administration or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p><b>Required:</b></p><p>At least 4 years of audit experience in compliance, delegation oversight, or audit within the healthcare industry.</p><p>Demonstrated experience developing and delivering training programs and making presentations to internal staff and providers.</p><p>Experience in health care service plans with significant delegation arrangements. </p><p>Experience working with Policies and Procedures.</p><h4>Skills</h4><p><b>Required:</b></p><p>Ability to manage multiple priorities, projects and meet deadlines.</p><p>Superior written and verbal communication skills.</p><p>&nbsp;Ability to draft policies and procedures. </p><p>Exceptional analytical and problem-solving skills, with a meticulous attention to detail.</p><p>Strong communication and collaboration abilities, with the capacity to engage effectively with stakeholders at all levels.</p><p>Ability to create a work environment that fosters team building and encourages a collaborative approach to achieving departmental and organizational goals.</p><p>Proficient in Microsoft Office, Excel, and PowerPoint.</p><p>In-depth knowledge of federal and state laws, Medicaid regulations, and healthcare compliance standards.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certified HealthCare Compliance (CHC)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Healthcare Administration, Medicaid, Audit, Healthcare, Finance                                                    </p>

L.A. Care Health Plan

Delegation Oversight Compliance Auditor III

<p><b>Join the Clean Energy Revolution</b></p><p>Become a<b>&nbsp;Plant Accounting Manager</b>&nbsp;at Southern California Edison (SCE) and build a better tomorrow. In this job, you’ll be leading a team responsible for application of technical skills and expertise in Fixed Asset Accounting to perform and analyze capital related accounting transactions and analysis. Also, you will be managing capital work orders to ensure proper and timely capital cost recovery.</p><p>As a&nbsp;<b>Plant Accounting Manager</b>, your work will help power our planet, reduce carbon emissions and create cleaner air for everyone. Are you ready to take on the challenge to help us build the future?</p><h4><b>Responsibilities</b></h4><ul><li>Manages monthly close entries and account reconciliations and investigate significant variances for specific areas of responsibility. Ensures all account reconciliations are completed on a timely basis and meets the internal control requirements</li><li>Delivers the preparation of internal Financial Statements (Income Statement, Balance Sheet, Cash Flow) and coordinate all variance research related to actuals vs the prior year</li><li>Upholds the timely update to all internal control documentation on an on-going basis and coordinates with all Accounting departments on any identified weaknesses and appropriate action plan to remediate</li><li>Maintains compliance of all internal control requirements within the Accounting area</li><li>Directs numerous processes related to the Fixed Asset System, including the appropriate creation of fixed assets by ensuring all new items meet the Capital Policy requirements, retirement of fixed assets by enforcing a diligent review of existing assets and proper approvals on dispositions, depreciation posting and tracking, and on-going maintenance of the fixed asset system</li><li>Undertakes various process improvement initiatives across the Accounting area, including helping to identify efficiencies and potential opportunities for improvement that positively impact the workload throughout all of the Accounting operations</li><li>Coordinates budget preparation including establishing budgetary controls and procedures and ongoing financial forecasting</li><li>Prepares monthly procurement reports while managing purchases and encouraging a long-term cost-savings culture</li><li>Supports proposals for potential projects to improve and streamline processes, cost to collect and cash yield</li><li>Engages with external auditors on accounting and reporting, assists in the preparation and review of materials for the finance and audit committee meetings</li><li>A material job duty of all positions within the Company is ensuring the protection of all its physical, financial and cybersecurity assets, and properly accessing and managing private customer data, proprietary information, confidential medical records, and other types of highly sensitive information and data with the highest standards of conduct and integrity.</li></ul><h4><b>Minimum Qualifications</b></h4><ul><li>Five or more years of supervisory experience within an accounting and/or finance function</li><li>Interpreting and applying Generally Accepted Accounting Principles (GAAP)</li></ul><p><b>Preferred Qualifications</b></p><ul><li>Bachelor’s Degree or higher in Business, Economics or other related field.</li><li>Experience with PowerPlan software or similar Fixed Asset Accounting software.</li><li>Knowledge of utilities or regulated companies.</li><li>Experience with SAP or similar enterprise-wide ERP system.</li><li>Experience with data visualization tools, such as Power BI.</li><li>Experience with Alteryx.</li></ul><p><b>Additional Information</b></p><ul><li>This position’s work mode is&nbsp;<b>hybrid.&nbsp;</b>The employee will report to an SCE facility for a set number of days with the option to work remotely on the remaining days. Unless otherwise noted, employees are required to work and reside in the state of California. Further details of this work mode will be discussed at the interview stage. The work mode can be changed based on business needs.</li><li>Visit our&nbsp;Candidate Resource&nbsp;page to get meaningful information related to benefits, perks, resources, testing information, hiring process, and more!</li><li>Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.</li></ul><p><b>About Southern California Edison</b></p><p>The people at SCE don't just keep the lights on. Our mission is so much bigger. We’re fueling the kind of innovation that’s changing an entire industry, and quite possibly the planet. Join us and create a future with cleaner energy, while providing our customers with the safety and reliability they demand. At SCE, you’ll have a chance to grow personally and professionally, making a real impact in Southern California and around the world.</p><p>At SCE, we celebrate our differences. We are a proud Equal Opportunity Employer and will not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected status.</p><p>We are committed to ensuring that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodations at (833) 343-0727.</p>

Southern California Edison

Plant Accounting Manager

<p><b>Salary Range:&nbsp;</b>&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Financial Compliance Auditor III Claims is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with L.A. Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in a timely and efficient manner. For Claims Emphasis: This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the audit report. This position is responsible for a variety of complex areas of the Medi-Cal, Medicare, Covered California, and PASC-SEIU benefit and process. This position audits focuses on contractual and regulatory compliance with timeliness and appropriateness standards. This position is responsible for other ongoing tasks as assigned by the Manager of Financial Compliance. These assignments may include claims data reporting in the Online Monitor Tool (OMT), compiling Monthly Timeliness Report (MTR), completion of the financial statement analysis, and Plan Partner oversight of their Independent Practice Association (IPA) network on a quarterly &amp;&nbsp;annual basis.</p><p>Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Perform auditing procedures under minimal supervision during the&nbsp; audits of medical groups and health plans. Provide timely and accurate reports that detail whether medical groups and health plans are meeting certain regulatory and contractual requirements. Communicate issues and findings that would affect the audit results.</p><p>Perform claims audits for all medical groups and health plans contracted with L.A. Care. Timely audit reports presented to supervisor with one week of the audit date. Communicate issues and findings that would affect the audit results.</p><p>Perform analysis of medical groups and plan partners.</p><p>Set up financial audit work papers. Perform certain administrative functions for the audit team. Set up completely and timely work papers needed prior to going on site for the claims audits.</p><p>Perform other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4><p><b>Required:</b><br>A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal MediConnect, and/or other managed care product lines similar to L.A. Care’s, L.A. Care Covered, and PASC-SEIU programs.</p><h4>Skills</h4><p><br><b>Required:</b><br>Must be self-motivated.</p><p>Detail-oriented.</p><p>Able to prioritize assignments, and able to work as part of a team.</p><p>Excellent verbal and written communication skills.</p><p>Ability to interface professionally with both internal and external customers at all levels of the organization.</p><p>Must also have flexible mode of transportation for considerable amount of travel to work off-site.</p><p>Knowledge and understanding of legislation and regulatory bodies affecting healthcare practices.</p><p>Knowledge of medical records systems applications.</p><p>Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters.</p><p>Knowledge of health insurance products, market segments and marketplaces.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Delegates</b>:&nbsp; This position also conducts sub-delegation claims oversight audit of the PPGs, capitated hospitals and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Claims, Audit, Medicare, Financial, Insurance, Finance, Healthcare                                                    </p>

13 Accounting Jobs in Burbank, CA, USA