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
Click
here to apply!
|