Principal Configuration Auditor and Trainer

Company: Prospect Medical Systems - CA
Location: Orange
Posted on: May 7, 2022

Job Description:

Current Employees Click HERECurrent employees can apply directly through the Internal Careers Center online for Prospect Medical job openings in California. For a streamlined application process, all you need is your four-digit employee ID number and a digital copy of your r--sum-- handy before you apply.Note: Internal applicants not eligible for any Sign On Bonus.Principal Configuration Auditor and Trainer - Full Time, Days (Orange, Ca)We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.The Principal Configuration Auditor and Trainer is responsible for auditing the Configuration team, including developing and maintaining various reports. Serve as the principal technical lead on configurations and work directly with management teams. Provide audit scores and feedback, track and maintain error logs for staff for process improvements. Answer Configuration team questions and trouble shoot, train staff based on error trends identified, meet audit production standards set for the department, alert leadership of process changes needed and update documentation, review of Division of Financial Responsibility (DOFR), health plan guidelines and other regulatory guidelines to provide recommendations on configuration design and impact. Have the ability to back up configuration team as needed and test claims to ensure configuration design is working as intended. Monitor and communicate error trends and process improvement opportunities to team and leadership. Develop and conduct training based on trends identified.Job Responsibilities/DutiesServe as the departments contact to coordinate project and design reviews for configuration audits and provide training as neededProvide supervision, training, work direction and oversight of Configuration auditsProvide highly advanced technical and administrative expertise, audit reports, deliver presentations, perform resource and workload management, and conduct reviews of team successes and lessons learnedAnalyze and interpret complex data, develop project plans to implement solutions for complex technical and operational problemsResponsible for creation, implementation, and management of audit metrics, utilizing Vizio, power point, excel, IDX and other systems as implemented and applicableCoordinate with General Auditor in reviewing and revising audit programsDaily auditing/monitoring of staffDevelop audit plans and prepare audit presentations for assigned projectsDiscuss with management about audit findings and recommendationsEnsure that management clearly understands and implements audit recommendationsEvaluate performance of other Auditors and provide feedback for improvementsAssist in development and revision of audit policies and proceduresResolve audit issues and escalate complex issues to appropriate teams for analysisOversee issues tracking, resolution and closing activitiesBuild positive and professional working relationships with business teamsCommunicate effectively to the Configuration team and leadership teamsReporting errors, root cause analysis, and recommended best practicesWork with audit teams to plan, prioritize and perform audit works to ensure timely completionsInterview Managers, Users and other department staffs to obtain information required for auditsPrepare audit reports as per departmental standardsProvide job assistance to other Auditors when requiredDocument audit results and recommendations and deliver to managementEvaluate company risks management and governance processes and recommend improvementsAnswer Configuration team questions and trouble shootTrain staff based on error trends identified, meet audit production standards set for the departmentAlert leadership of process changes needed and update documentation, review of Division of Financial Responsibility (DOFR), health plan guidelines and other regulatory guidelines to provide recommendations on configuration design and impactAbility to back up configuration team as needed and test claims to ensure configuration design is working as intendedPerform other duties as assignedQualificationsMinimum Education: High school diploma required. Bachelor's Degree, or equivalent education and experience required.Minimum Experience: Thorough understanding of ICD-9, CPT and HCPCS codes. Ability to read and interpret health plan contracts and/or contract summaries and division of financial responsibilities (DOFR) required. Preferred configuration experience. Preferred auditing and training experience.Req. Certification/Licensure: None.Employee Value PropositionProspect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals, benefit eligible positions will receive:Company 401KMedical, dental, vision insurancePaid time-offLife insuranceProspect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol. Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm. For this reason, we require applicants to pass a screening for drug use as a condition of employment. This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.How to ApplyTo apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.EEOC is the Law: https://www.eeoc.gov/Position SummaryEmployment Status: Regular Full-timeShift: DaysWork Schedule: Monday - FridayAddress: Orange - 600 City Parkway West, Suite 800

Keywords: Prospect Medical Systems - CA, Orange , Principal Configuration Auditor and Trainer, Human Resources , Orange, California