Top 3 Auditor lvn Jobs in California

Delegation Oversight
Champion Health Plan —Long Beach, CA
- From $60,000 a year
- Full-time
- Microsoft Excel
- LVN
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Billing Compliance Auditor
HOSPICE OF SAN JOAQUIN —Stockton, CA
- $24.60 - $25.60 an hour
- Full-time
- Microsoft Word
- Background check
- Microsoft Outlook
- Mileage reimbursement
- Health insurance

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Delegation Oversight

Champion Health Plan
Long Beach, CA

Quick Apply

Job Details

Full-time
From $60,000 a year

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Teamwork
Microsoft Excel
CMS
Master's degree
CMS regulatory compliance
Documentation tools
Bachelor's degree
Health insurance knowledge
Organizational skills
Productivity software

Full Job Description

Delegation Oversight Specialist

Position Summary:
The Delegation Oversight Specialist is responsible for overseeing all components of health plan delegation oversight, including audits, internal reviews, and performance monitoring to ensure compliance with regulatory and contractual requirements. This position plays a critical role in supporting audit readiness, quality initiatives, and interdepartmental collaboration across delegated functions.

Primary Responsibilities:

Prepare and submit pre-audit documentation in alignment with health plan tools and timelines
Coordinate, conduct, and document pre-delegation and annual oversight audits to comply with NCQA, CMS, DMHC, DHCS, and other applicable standards
Facilitate onsite, virtual, and desktop audits to evaluate adherence to plan-specific and regulatory requirements
Serve as the main point of contact for health plan auditors and regulatory bodies during all audit phases
Distribute audit result letters, follow-up communications, audit tools, and annual reporting requirements
Conduct internal audits of the end-to-end departments process and perform focused audits based on trends, CAPs, or new workflows
Collaborate with internal teams to collect and review required documentation and ensure timely responses to audit requests
Assist in the preparation of audit summaries, internal dashboards, and reports for Committees and Joint Operations Committees (JOCs)
Monitor performance of delegated entities and support continuous quality improvement initiatives

Minimum Qualifications:

Bachelor’s degree in Healthcare Administration, Public Administration, Health Policy, or a related field (Master’s degree preferred)

OR equivalent combination of education and relevant managed care experience

Experience working in a managed care organization, HMO, MSO, or health plan setting
Working knowledge of NCQA standards, CMS, DMHC, and DHCS regulatory requirements
Familiarity with prior authorization and utilization management processes
Advanced proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)
Experience with Quick CAP, EZ-CAP, or similar health plan systems is a plus

Preferred Qualifications:

3+ years of experience in healthcare operations, managed care, utilization management, or quality oversight
Experience supporting delegated entities such as provider groups, IPAs, or MSOs
Prior involvement with audit preparation, corrective action plans (CAPs), and regulatory reporting
Exposure to NCQA accreditation readiness or survey support
Excellent organizational, analytical, and written/verbal communication skills
LVN/LPN licensure is a plus but not required

Job Type: Full-time

Pay: From $60,000.00 per year

Benefits:

401(k)
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Ability to Commute:

Long Beach, CA 90815 (Required)

Ability to Relocate:

Long Beach, CA 90815: Relocate before starting work (Required)

Work Location: In person

Quick Apply

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auditor lvn jobs in california

Delegation Oversight

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