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Specialty Health Plans Auditor III – Finance
Location: Los Angeles, CA (Onsite)
Overview:
We are seeking a Specialty Health Plans Auditor III with a finance focus to lead planning, execution, reporting, and corrective action initiatives related to financial solvency oversight for specialty health plans and delegated vendors. This includes medical, dental, vision, behavioral health, transportation, and telehealth provider networks. This role ensures compliance with regulatory requirements and contractual obligations across multiple lines of business.
Key Responsibilities:
* Perform quarterly and annual financial audits and analyses for specialty health plans and delegated vendors
* Provide accurate, timely deliverables supporting financial solvency compliance for provider groups, capitated hospitals, specialty plans, and related partners
* Develop and maintain standardized audit workpapers, reporting templates, and monitoring tools
* Review and update departmental policies and procedures annually
* Support internal oversight requests and collaborate with legal and compliance partners
* Communicate effectively with leadership, cross-functional teams, and vendor partners
* Assess regulatory changes impacting internal processes and implement recommended solutions
* Contribute to special projects focused on process improvement and reporting enhancements
* Provide subject-matter expertise, training, and mentorship to junior auditors and staff
Qualifications:
* Bachelor’s degree in Accounting or related field (or equivalent experience)
* Master’s degree preferred
* Minimum 4 years of financial audit experience
* Minimum 5 years of experience within managed healthcare
* Strong analytical, critical-thinking, and problem-solving skills
* Excellent verbal and written communication skills
* Ability to work independently, prioritize, and meet deadlines
* Comfortable interfacing with stakeholders at all organizational levels
* Proficient in Excel, PowerPoint, SharePoint, and Microsoft Office Suite
Preferred Certifications:
* CPA, CIA, CFE, or CMA (one or more preferred)
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