Compliance Auditor II

## 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…