Financial Compliance Auditor III, Finance - SOLUGENIX : Job Details

Financial Compliance Auditor III, Finance Los Angeles, CA (Hybrid) 3-Month Contract to Hire Job ID 25-09689 Solugenix is assisting a client, a health insurance company, in their search for a Financial Compliance Auditor III, Finance. This is a 3-month contract to hire opportunity based out of Los Angeles, CA (Hybrid). The Financial Compliance Auditor III Finance is a hybrid role and is responsible for various tasks within the Financial Compliance Unit which include, but not limited to, performing, reporting, and corrective action plan monitoring of financial solvency reviews of plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors contracted with the Client. This position is responsible for the overall financial solvency compliance ongoing monitoring of assigned delegates across all lines of business including Medi-Cal, Covered California, D-SNP, and PASC-SEIU. This role works closely with the Manager and other team members on the identification and resolution of issues in a timely and efficient manner. This position leads assigned audits independently in accordance with generally accepted auditing standards, generally accepted accounting principles (GAAP), regulations of the Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Centers for Medicare and Medicaid Services (CMS), and other federal and state guidelines. Responsible for the ongoing communication, collaboration, and issue resolution on financial solvency issues with interdepartmental personnel, key stakeholders, and delegates. Serves as a subject matter expert, and mentor for other staff. Qualifications: Education Required: ssociate's Degree: In lieu of a degree, equivalent education and/or experience may be considered. Experience Required: t least 5 years of experience performing financial audits with the demonstrated experience on the following list of stated knowledge/experience: Skills Required:

• Must be self-motivated.
• Detail-oriented.
• Excellent verbal and written communication skills.
• Strong analytical and critical thinking skills.
• ble to prioritize assignments, and able to independently with minimum supervision. Ability to interface professionally with both internal and external customers at all levels of the organization.
• Proficiency in Microsoft Office (Excel, PowerPoint, and SharePoint).
• Must also have a flexible mode of transportation for a considerable amount of travel to work off-site.

Preferred:

• Healthcare experience
• Financial audits
• Financial analysis

Responsibilities:

• This position is responsible for all aspects of financial solvency reviews including, but not limited to, the planning, execution, continuous monitoring, and reporting of annual financial audits, quarterly and annual financial analyses (ratio and trending analyses), and special projects.
• Provides timely and accurate deliverables to ensure financial solvency compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors.
• Supports the design, implementation, and reporting of special projects such as Medical Loss Ratio.
• Supports the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications.
• Supports the assessment, communication, and implementation of regulatory requirements that may impact internal processes.
• Supports the formalization of key internal processes and monitoring tools with desktop procedures and applicable policies and procedures development.
• Responsible for the financial audit team's pre-delegation reviews and delivers monthly/quarterly request updates to various business units.
• Responsible for the completion and monitoring of monthly membership reports.
• ccountable for the completion of requests from the Legal Department, Delegation Oversight's monitoring oversight and reporting.
• Communicates issues and findings in a concise and timely manner.
• Serves as subject matter expert in assigned areas and cross-training initiatives.
• Responsible for the overall communication and collaboration with interdepartmental personnel, leadership, and delegates.
• Identifies areas where technical solutions would improve business performance.
• Consults across business operations, providing mentorship and contributing specialized knowledge.
• Ensures that the facts and details are correct so that the project's/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices.
• Provide training, recommend process improvements, and mentor junior-level staff, department interns, etc. as needed.
• Performs other duties as assigned.

Licenses/Certifications Required: t least one of the following: Certified Public Account (CPA) or Certified Internal Auditor (CIA) or Certified Fraud Examiner (CFE) or Certified Information Systems Auditor (CISA). Pay Range for CA, CO, IL, NJ, NY, WA, and DC: $63/hour to $66/hour. Starting rate of pay offered may vary depending on factors including but not limited to, position offered, location, education, training and/or experience. Solugenix will consider qualified applicants with a criminal history pursuant to the California Fair Chance Act and Ordinance. Applicants do not need to disclose their criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if we are concerned about conviction that is directly related to the job, applicants will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. About the Client Our client is one of the world's leading health insurance companies based out of Los Angeles, CA. About Solugenix Solugenix is a leader in IT services, delivering cutting-edge technology solutions, exceptional talent, and managed services to global enterprises. With extensive expertise in highly regulated and complex industries, we are a trusted partner for integrating advanced technologies with streamlined processes. Our solutions drive growth, foster innovation, and ensure compliance-providing clients with reliability and a strong competitive edge. Recognized as a 2024 Top Workplace, Solugenix is proud of its inclusive culture and unwavering commitment to excellence. Our recent expansion, with new offices in the Dominican Republic, Jakarta, and the Philippines, underscores our growing global presence and ability to offer world-class technology solutions. Partnering with Solugenix means more than just business-it means having a dedicated ally focused on your success in today's fast-evolving digital world.