- Pharmacy overseeing their work auditing and overseeing the PBM.
Lead Auditor, Delegation Oversight - Long Beach, United States - Molina Healthcare
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Description
Job DescriptionJob DescriptionJob SummaryThe Lead Auditor, Delegation Oversight is responsible for leading and managing the auditing of complex and multi-delegated high-risk vendors.
Scope for this position will include:
Performing audits of complex and multi-delegated high-risk vendors compliance programs, fraud/waste/abuse programs, HIPAA and financial solvency. Works daily with the Senior Auditor, Delegation Oversight
Job Duties Manages regulatory and contractual change management process ensuring that all auditing tools, documents, policies, and procedures incorporate and comply with State, Federal, NCQA and any other applicable requirements.
Assists in standardization and improving auditing best practices. Leads, prepares, and coordinates delegation oversight document evidence for external accreditation and regulatory audits. Oversees, tracks, and monitors Corrective Action Plans for National and State delegates for the auditing and oversight team. Prepares and submits reports to Delegation Oversight Committees, Quality Improvement Committees regarding National and State delegate performance and compliance. Creates, schedules and documents staff training to ensure auditors are trained on updates to internal processes and/or regulatory requirements. Perform annual oversight audits of delegated entities, provides audit findings and results according to designated timelines. Presents audit findings and makes recommendations to management for improvements based on audit results. Conducts focused audits on subcontractors, as applicable. Complete all mandatory compliance training annually or as required by leadership.Job QualificationsREQUIRED EDUCATION:
Bachelor's Degree or equivalent, combination of education and experienceREQUIRED EXPERIENCE/KNOWLEDGE, SKILLS &
ABILITIES:
5 years related auditing experience Strong relationship building and management experience Ability to manage multiple stakeholders and competing priorities Excellent communication skills, time management, organizational and prioritization skills Strong project management skills and knowledge of project management tools/processes Detail oriented and organized Excellent verbal and written communication skillsTo all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.