Sr. Compliance Audit Analyst
Job Summary (This job's purpose and primary focus.) The SCPMG Compliance Audit Analyst is responsible for partnering with local and regional senior leaders and physicians to ensure adherence with Southern California Permanente Medical Group (SCPMG) Compliance Framework and other federal and state regulatory standards. This is a highly visible position that is responsible for conducting audits to ensure physician compliance with Partnership Rules and Regulations, Board approved guidelines and pay practices, and other organizational initiatives.
Major Responsibilities/Essential Functions (The primary job duties this position is responsible for achieving are listed in order of importance.)
Estimated % of Time Spent
* Assume key responsibility for planning, scheduling and performing SCPMG compliance audits including, but not limited to, physician pay practices, operational and physician workflow processes, determination of risks, controls, efficiency, accuracy and compliance with the SCPMG Partnership Rules and Regulations, Board approved programs and guidelines, organizational initiatives, and other Federal and State regulatory agency policies and regulations. * Conducts quantitative and qualitative analyses based on various data sets and formulate conclusions, recommendations, and improvement opportunities. * Determine scope, objectives, and procedures to be performed for each audit. * Obtain, analyze and appraise evidentiary data for an informed, objective opinion on the adequacy, accuracy and effectiveness of the system(s) and activities being reviewed. * Ensure that work papers contain audit evidence necessary to support audit findings. * Oversees the identification of risks and opportunities to the Partnership, as well as develops appropriate corrective/management action plans. * Prepare accurate and timely formal written reports/memos and make oral and power-point presentations to management on findings and recommendations. * Provide innovative and creative ideas to formulate new audit approaches, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and SCPMG policies and procedures as well as specific departmental/organizational initiatives. * Accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior service and SCPMG Rules and Regulations, Policies and Procedures. * Interacts and maintaining relationships with physicians, medical center and regional leadership, risk management teams, and other internal and external contacts. * Opportunities to work on other types of audit (e.g. operational, financial, SOX, etc.) as needed based on department goals.
Bachelor's degree required
Minimum Work Experience and Qualifications (Indicate minimum years of job experience, skills or abilities required for the job.) Basic Qualifications: * Minimum of five (2) years of health care compliance, health care operations (quality, risk, etc.) audit, finance, project management, regulatory or public policy development, investigations experience or equivalent.
Additional Requirements: * Demonstrated skills in the identification and resolution of business problems within a team setting. * Demonstrated success in maintaining strong customer focus and achieving high levels of customer satisfaction. * Excellent oral and written communication skills. * Must be able to work in a Labor/Management Partnership environment.
Preferred Work Experience and Qualifications (Indicate preferred years of job experience, skills or abilities required for the job.) * Strongly prefer one of the following certificates: Certified Public Accountant (CPA) - Certified Internal Auditor (CIA) - Certified Information System Auditor (CISA), Certified Fraud Examiner (CFE). * Emphasis in business, finance, accounting, or information systems preferred. Top Daily Responsibilities: Conducts quantitative and qualitative analyses based on various data sets and formulate patterns and conclusions
Top (3) Required Skills Candidate Should Have: Analytical Skills, Communication Skills, Project Management Skills
Additional Skills Preferred (Not Required): Auditing