Director, Financial Compliance

Job Summary

The Director of Financial Compliance is responsible for a variety of complex areas in the Medi-Cal, D-SNP, PASC-SEIU, and Medicare benefit and process. This position directs the audit team on all aspects of health plans, capitated hospitals, and medical groups’ financial solvency audits, claims audits, quarterly/annual financial analysis, Online Monitoring Tool (OMT) and Monthly Timeliness Report (MTR) reporting. This includes audit planning, audit assignments, and ensuring completion of audit calendar and reporting. This position measures auditee compliance with appropriate Federal and State regulatory standards and prepares summary reports of findings for the Sr. Director of Financial Compliance and for distributions internally & externally. In addition, this position provides guidance based on generally accepted accounting principles, generally accepted auditing standards, Centers for Medicare and Medicaid Service (CMS), California Department of He...