Top 118 Compliance auditor Jobs in Ontario, Ca

Compliance Auditor II
Inland Empire Health Plan —Rancho Cucamonga, CA
- $80,059.20 - $106,059.20 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Disability insurance
- Health insurance
Senior Quality Control Manager
Thompson Pipe Group —Rialto, CA
- $120,000 a year
- 12 hour shift
- Ability to walk for extended periods
- Pass drug screening
- Ability to lift 50 pounds
- Paid training
- Paid holidays
Call Center Quality Assurance Auditor
United Faith Ministries Inc —Orange, CA
- $26 an hour
- Full-time
- Spanish
- HIPAA
- English
- 403(b) matching
- Health insurance
Quick Apply
Lead Internal Auditor
HF Foods Group —City of Industry, CA
- $90,000 - $130,000 a year
- Full-time
- Microsoft Excel
- CPA
- 5 years
- Disability insurance
- Health insurance
Quick Apply
Night Auditor
Hilton —Ontario, CA
- $19 an hour
- Full-time
- Hospitality
- Hotel
- Entry level
- Paid parental leave
- Employee stock purchase plan
Risk Compliance Analyst
Panda Restaurant Group —Rosemead, CA
- $72,500 - $101,500 a year
- Email
- Hybrid work
- Mid-level
- 3 years
- Bachelor's degree
- AD&D insurance
- Disability insurance
Quick Apply
Auditor
DHL —Bloomington, CA
- $22.50 an hour
- Full-time
- Computer literacy
- Basic math
- Forklift
- Paid holidays
- Health insurance
Quick Apply
Night Auditor
Rancho Cucamonga Hilton Garden Inn by Hilton —Rancho Cucamonga, CA
- $19 an hour
- Part-time
- Hotel
- Entry level
- Profit sharing
- Health insurance
Quick Apply
6d
Night Auditor
Rancho Cucamonga Courtyard by Marriot —Rancho Cucamonga, CA
- $17.90 - $19.00 an hour
- Part-time
- Hotel
- Entry level
- Profit sharing
- Health insurance
Quick Apply
OP Coder Auditor Trainee
Prime Healthcare Management Inc —Ontario, CA
- $26.04 - $32.37 an hour
- Full-time
- Nursing
- Computer literacy
- Typing
- Health insurance
- Dental insurance
13d
Coder Auditor
Prime Healthcare Management Inc —Ontario, CA
- $28.00 - $43.40 an hour
- Full-time
- Nursing
- Anatomy knowledge
- Mid-level
- Health insurance
- Dental insurance
1d
Senior Compliance Analyst
LSMA Management Inc —San Bernardino, CA
- $85,000 - $95,000 a year
- Hybrid work
- HIPAA
- Mid-level
- Analysis skills
2d
Remote Medicare Risk Adjustment Coding/ Auditor (Prior CMS-HCC V28 required)
Alignment Healthcare USA, LLC —Orange, CA
- $64,384 - $96,577 a year
- Full-time
- Remote
- Microsoft Outlook
- Basic math
- HIPAA
Quick Apply
Regulatory & Compliance HC Specialist 4 - Risk Management FT Days
University of California, Irvine —Orange, CA
- $123,000 - $237,800 a year
- Full-time
- Background check
- RN License
- Customer service
- Health insurance
- Retirement plan
3d
QA Auditor
Avid Bioservices —Tustin, CA
- $103,200 - $129,000 a year
- Overtime
- Bachelor of Science
- Data analysis skills
- Mentoring
- Health insurance
- Dental insurance
Quick Apply
Night Auditor
Rebel Hotel Company —Riverside, CA
- Full-time
- Hotel
- Front desk
- Entry level
Quick Apply
DoubleTree Pomona - Night Auditor
Aimbridge Hospitality —Pomona, CA
- $18.50 an hour
- Full-time
- Microsoft Word
- Windows
- Hotel
- AD&D insurance
- Disability insurance
Staff Internal Auditor
Cathay Bank —El Monte, CA
- $69,600 - $76,600 a year
- Full-time
- Microsoft Word
- Office
- Finance
- Health savings account
- Disability insurance
Quick Apply
3d
Animal Research Training and Compliance Specialist (Hybrid)
City of Hope —Duarte, CA
- $33.80 - $52.29 an hour
- Full-time
- 5 years
- Mid-level
- Bachelor's degree
Healthcare Coding Compliance Auditor - RUHS
County of Riverside —Riverside, CA
- $105,597.80 - $145,114.92 a year
- Background check
- Office
- Finance
- Paid holidays
- Disability insurance

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Compliance Auditor II

Inland Empire Health Plan -
Rancho Cucamonga, CA

Apply Now

Job Details

Full-time
$80,059.20 - $106,059.20 a year

Benefits

457(b)
Disability insurance
Health insurance
On-site gym
Dental insurance
Flexible spending account
Vision insurance
Opportunities for advancement
Life insurance

Qualifications

Managed care
Managed care organization experience
Health insurance knowledge
Quality improvement
Healthcare quality audits

Full Job Description

Overview:

What you can expect!

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

The Compliance Auditor II conducts comprehensive audits and reviews across the Plan, including assigned areas and Plan delegates, to ensure adherence to Federal, State, and contractual regulatory requirements. Identifies and assesses risks impacting overall compliance, drafts detailed audit findings and actionable recommendations, and evaluates operations, policies, and processes throughout the Plan. Conducts evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues. Issues corrective action plans and reviews for acceptance to ensure that all compliance issues are appropriately addressed. Performs validation audits to determine if actions have been taken to mitigate identified risks and conducts routine monitoring across the Plan to address compliance concerns and emerging risks. Participates in special reviews as necessary.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits:

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

Competitive salary
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Life, short-term, and long-term disability options
Career advancement opportunities and professional development
Wellness programs that promote a healthy work-life balance
Flexible Spending Account – Health Care/Childcare
CalPERS retirement
457(b) option with a contribution match
Paid life insurance for employees
Pet care insurance

Key Responsibilities:

Conduct audits and testing procedures of assigned areas and Plan delegates, including detailed testing activities, documenting findings in audit work papers, developing detailed document requests lists, conducting walk-throughs, and proposing recommendations for improvement.
Develop and maintain audit tools based on regulatory compliance with DHCS, DMHC, and CMS requirements.
Document audit conclusions that are based on a complete understanding of the process, circumstances, and risk.
Perform validation audits to determine if actions have been taken to mitigate risks identified.
Support the development and acceptance of corrective action plans (CAPs) from internal departments and delegates to ensure accuracy and regulatory adherence.
Validate corrective action plans (CAPs) from internal departments and delegates to ensure appropriate completion and make necessary recommendations as needed for compliance.
Perform evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues.
Support the identification of and communicates issues raised, offering recommended solutions relevant to business and risk.
Conduct regulatory research and provides interpretation of regulations to ensure appropriate application.
Support the maintenance of risks for assigned areas in the Compliance Risk Universe to ensure risk mitigations plans are developed and risks assessed and refreshed as needed.
Support the development of risk assessments to identify compliance risks posed to the Plan.
Conduct routine monitoring activities to ensure compliance with regulatory and contractual requirements.
Assist with reports for presentation to the Executive Compliance Committee and the IEHP Governing Board.
Conduct compliance assessments as needed.
Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Qualifications:

Education & Requirements

Minimum or five (5) or more years in managed care operations requierd, working with one or more of the following areas: Utilization Management, Claims, Pharmacy Operations, Compliance, Delegation Oversight, Quality Management, Care Management, and/or Grievances and Appeals
Demonstrated experience, at a professional level, in an audit role
Experience with interpretation and/or implementation of California managed care regulations
Two (2) years of audit or quality assurance/quality improvement experience required
Bachelor’s degree from an accredited institution required
- In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position
- This experience is in addition to the minimum years listed in the Experience Requirements above
Certified Internal Auditor (CIA), Certified Health Care Compliance (CHC), Certified Healthcare Auditor (CHA), and/or CHIAP (Certified Healthcare Internal Audit Professional) preferred

Key Qualifications

Demonstrated understanding of audit standards and requirements, statistical data interpretation and applicability, risk assessment and control environments, audit theory and processes, and of the professional practice standards of internal auditing
Demonstrated current knowledge of business ethics and compliance risks and the knowledge to assist with management of those risks in a dynamic health care environment
Proficient knowledge of CMS Program Audit Protocols, DHCS Technical Assistance Guides, and DMHC Technical Assistance Guides
Knowledge of regulatory research and regulations that apply to California Managed Care Health Plans
Possess strong written and verbal communication skills, including a strong business writing aptitude
Possess strong problem solving and creative thinking skills and the ability to reprioritize workload as needed
Must be detail oriented, self-directed, and work with minimal supervision, both independently and in teams
Requires well-developed skills in problem identification, analysis, resolution, organization, prioritization, timeliness, and attention to detail
Proficient in Microsoft applications (Word, Excel, PowerPoint, Outlook, etc.). Advanced skills in MS Excel preferred
Effective in a consulting role with the ability to become a trusted advisor
Ability to maintain excellent interpersonal relationships within the department and at all levels of the organization
Ability to organize thoughts and data into well-organized communications and reports

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location:

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)

Pay Range: USD $80,059.20 - USD $106,059.20 /Yr.

Apply Now

Refine Your Search

compliance auditor jobs in ontario, ca

Compliance Auditor II

Senior Quality Control Manager

Call Center Quality Assurance Auditor

Lead Internal Auditor

Night Auditor

Risk Compliance Analyst

Auditor

Night Auditor

Night Auditor

OP Coder Auditor Trainee

Coder Auditor

Senior Compliance Analyst

Remote Medicare Risk Adjustment Coding/ Auditor (Prior CMS-HCC V28 required)

Regulatory & Compliance HC Specialist 4 - Risk Management FT Days

QA Auditor

Night Auditor

DoubleTree Pomona - Night Auditor

Staff Internal Auditor

Animal Research Training and Compliance Specialist (Hybrid)

Healthcare Coding Compliance Auditor - RUHS

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