Kaiser Permanente Sr. SCPMG Compliance Audit Analyst in Pasadena, California
The Sr. 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.
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.
- Minimum five (5) years of health care compliance, health care operations (quality, risk, etc.) audit, finance, project management, regulatory or public policy development, investigations experience or equivalent.
- Bachelor's degree required.
License, Certification, Registration
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.
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.
TITLE: Sr. SCPMG Compliance Audit Analyst
LOCATION: Pasadena, California
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.