- Medical, Dental and Vision
- Wellness Program
- Paid Sick Leave
-
Quality Auditor
3 weeks ago
SQA Services Los Angeles, United StatesSQA is a leading Quality Assurance and Supply Chain solutions firm. SQA manages Supplier Audit and Supplier Development programs for clients in quality-critical industries, including Pharmaceutical, Medical Device, Automotive, Aerospace, and Electronics manufacturing. Clients lev ...
-
Quality Auditor
3 days ago
AFL Los Angeles, United StatesThe Quality Auditor will be responsible for attending/auditing telecommunication sites (Central Office) where they will ensure completed builds (both upgrades and new installations, active and passive elements) have been installed/constructed in accordance with the site design an ...
-
Claims Quality Auditor
2 days ago
UCLA Health Los Angeles, United StatesTake on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. · The Claims Quality Auditor will b ...
-
Quality Assurance Auditor
3 weeks ago
Patco Brands Los Angeles, United StatesPatco Brands is one of the fastest growing beverage companies in the United States. Independently owned, Patco has established itself by using 100% Blue Weber Agave and a proprietary process to innovate within the fast growing ready-to-drink spirits category. · Patco is a maker ...
-
Claims Quality Auditor
6 days ago
UCLA Health Los Angeles, United StatesGeneral Information · Press space or enter keys to toggle section visibility · Work Location: Los Angeles, USA · Onsite or Remote · Flexible Hybrid · Work Schedule · Monday - Friday, 7:00am - 3:30pm PST · Posted Date · 01/30/2024 · Salary Range: $ Hourly · Employment Type · 2 - S ...
-
Claims Quality Auditor
6 days ago
University of California Los Angeles, United StatesTake on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. · The Claims Quality Auditor will be ...
-
Claims Quality Auditor
1 day ago
University of California Los Angeles, United StatesTake on an important role within a world-class health organization. Provide specialized expertise that enables the efficient operation of a complex health system. Take your career to the next level. You can do all this and more at UCLA Health. · The Claims Quality Auditor will b ...
-
Performance Quality Auditor I
1 week ago
Elevance Health Los Angeles, United States Full timeJob Description · : Performance Quality Auditor I · Location: This is a remote position. The ideal candidate will live within 50 miles of an Elevance Health PulsePoint office location. · The Performance Quality Auditor I is responsible for evaluating the quality of services ...
-
GMP Quality Assurance Auditor
3 weeks ago
SciPro Inc. Los Angeles, United States FreelanceWe are looking for an experienced QA Auditor, to audit suppliers and CDMO's for a CAR-T Biotech client in California. This role will be to support a few small audits, however, we are looking for someone that has capacity to work with a number of other clients as we are seeing a d ...
-
Claims Quality Auditor
2 weeks ago
UCLA Health Los Angeles, United StatesGeneral Information · Press space or enter keys to toggle section visibility · Work Location: Los Angeles, USA · Onsite or Remote · Flexible Hybrid · Work Schedule · Monday - Friday, 7:00am - 3:30pm PST · Posted Date · 01/30/2024 · Salary Range: $ Hourly · Employment Type · 2 - S ...
-
Quality Assurance Auditor
3 weeks ago
24 Seven Talent Los Angeles, United StatesOur beverage client is looking to bring on a Quality Assurance Auditor to their team on a fulltime basis, sitting in California or on the West Coast as this role will require travel. · Responsibilities: · Travel to all production and co-manufacturing facilities on a regular bas ...
-
Quality Assurance Auditor
3 weeks ago
Patco Brands Los Angeles, United StatesPatco Brands is one of the fastest growing beverage companies in the United States. Independently owned, Patco has established itself by using 100% Blue Weber Agave and a proprietary process to innovate within the fast growing ready-to-drink spirits category. · Patco is a maker ...
-
Quality Assurance Auditor
3 weeks ago
24 Seven Talent Los Angeles, United StatesOur beverage client is looking to bring on a Quality Assurance Auditor to their team on a fulltime basis, sitting in California or on the West Coast as this role will require travel. · Responsibilities: · Travel to all production and co-manufacturing facilities on a regular basi ...
-
Quality Auditor
2 weeks ago
HydraFacial Long Beach, United States Full timeDescription · : Hydrafacial, a leading medical device company, seeks a detail-oriented and experienced Auditor to join our Quality Assurance team. The ideal candidate will be responsible for conducting internal audits, preparing for external audits, and auditing suppliers to ens ...
-
Quality Auditor
5 days ago
BeautyHealth Long Beach, United StatesAbout Us · BeautyHealth is a global category-creating company focused on bringing innovative products to market and delivering beauty health experiences by reinventing our consumer's relationship with their skin, their bodies and their self-confidence. · Every person here is a ...
-
Manufacturing Quality Assurance Auditor
3 weeks ago
Spectraforce Technologies Los Angeles, United StatesPosition Title: · Manufacturing Quality Assurance Auditor · Location: · Woodland, CA · Duration: · 7 Months · Job Description: · Support a wide array of quality department tasks relating to developing and implement systems, procedures, and projects required to successfully ...
-
Provider Data Quality Auditor II
1 month ago
L.A. Care Health Plan Los Angeles, United StatesSalary Range: $55, Min.) - $69, Mid.) - $82, Max.) · 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 ...
-
Quality Assurance Auditor
3 weeks ago
Key Skilled San Fernando, United StatesJob Description · Job DescriptionQuality Assurance AuditorLocation: Sun Valley, CA, USShift: Monday – Friday, 1st shift 8:00 am – 5:00 pm Salary Range: $53,500.00 To 74,800.00 Annually Seeking a Quality Assurance Auditor to support its Quality Assurance department. Selected appl ...
-
Quality Assurance Auditor
3 weeks ago
Altasciences Cypress, United StatesYour New Company · At Altasciences we all · move in unison to assist and work in the discovery, development, and manufacturing of new drug therapies to get them faster to people who need them.No matter your role, we all play an important part and you will have a significant impa ...
-
Quality Auditor
1 month ago
Skyryse El Segundo, United States Full timeABOUT SKYRYSE: · Skyryse wants to empower anyone, to fly anywhere, in any aircraft, safely and as a highly experienced pilot would. Powered by SkyOS, we automate flight controls and systems management to achieve unmatched safety and eliminate opportunities for human error. We wan ...
Provider Data Quality Auditor II - Los Angeles, United States - L.A. Care Health Plan
![Default job background](https://contents.bebee.com/public/img/bg-user-ex-1.jpg)
Description
Salary Range:
$55, Min.) - $69, Mid.) - $82, Max.)
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 in five health plans, we make sure our members get the right care at the right place at the right time.
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.
Job SummaryThe Provider Data Quality Auditor II is responsible for the timely and accurate uploading of L.A. Care's provider network data, including identification and remediation of provider data errors. The Provider Data Quality Auditor must foster positive working relationships with both internal and external business partners, including L.A. Care's contracted ndependent Practice Association (IPAs), Medical Groups and Plan Partners.
This position must make independent decisions to ensure data quality measures, timelines and organizational policies are met related to provider network data.
The position is responsible to conduct ongoing data quality auditing of L.A. Care's provider network data, including working with their assigned provider network accounts to remediate provider data errors.Duties
Work in a metric driven environment and is expected to understand and work in accordance with all department and company provider data metrics.
Work with contracted partners to ensure timely, accurate and successful submissions of all required provider data elements via the Sender Policy Framework (SPF)/Provider Add Change Delete Workflow (PCDW) tasks by continuous provider network data quality oversight and auditing activities.
Must work to identify and triage all provider data quality issues.Responsible to ensure that Senate Bill 137 requirements are met, by meeting mandated update periods for the provider's name, practice location or locations, and contact information.
Responsible to manage and oversee all Data Fallout reporting as a result of SPF submissions from L.A. Care's contracted entities (IPAs, Medical Groups, Plan Partners, and Vendors). Knowledgeable of reporting formats for use in continuous data auditing, independent analysis of audit results, including root-cause analysis.Must be well-versed in written and verbal communications and is responsible for interacting with contracted partners and provide training and coaching activities to improve overall compliance with the SPF submission.
(35%)
Responsible for fostering and maintaining positive working relationships with contracted partners and providing training and coaching activities to improve overall data accuracy.
Must work collaboratively with Contracting and Relationship Management Account Managers to ensure that all provider data standards are met in accordance with contracts, regulations, accreditation standards, and L.A.
Care Policies and Procedures, including IPA and Medical Group terminations. (15%)Responsible to follow and execute appropriate procedures when administering provider data system overrides. Responsible to manage provider data quality issues for other L.A.
Care business units, including but not limited to, Customer Solutions Center, Provider Services, Contracting and Relationship Management, and Facility Site Review.
Responsible for understanding all data related contracts, regulations, accreditation standards, and L.A.Care Policies and Procedures and responsible to assist and train contracted partners about this information on an as needed basis.
(20%)
Must have a strong knowledge of Provider Relations and a understanding of how Independent Practice or Physician Association (IPA) and Medical Groups operate.
Care business units, including but not limited to, Customer Solutions Center, Provider Services, Contracting and Relationship Management, and Facility Site Review.
(15%)Manage and oversee all provider data fallout, including reporting of root-cause and resolution. (5%)
Perform other duties as assigned. (10%)
Duties Continued
Education Required
High School Diploma/or High School Equivalency Certificate
Education Preferred
Associate's Degree
Experience
Required:
Minimum of at least 0-2 years of work experience in healthcare or related industry working with data.
Provider Network interaction experience.
Preferred:
Provider Relations, management or sales experience.
Policy and procedure and desktop manual development experience.
Skills
Required:
Excellent communication skills, strong analytical skills, and ability to build strong customer relationships, including the ability to work effectively with diverse team members.
Ability to perform root-cause analyses and recommend effective alternative solutions to handle Provider and Member inquiries, and to provide optimal customer service for internal and external customers.
Ability to multitask in a face-paced work environment and recommend process improvement measures for day to day operations, wherever possible.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Light
Additional Information
Salary Range Disclaimer:
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
Nearest Major Market:
Los Angeles
Job Segment:
Audit, Relationship Manager, Finance, Customer Service