Senior Manager, Audit Administration

IT SupportIT SupportFull TimeRemoteTeam 501-1,000Since 2013H1B No SponsorCompany SiteLinkedIn

Location

California

Posted

27 days ago

Salary

$98.6K - $147.8K / year

Bachelor Degree6 yrs expEnglish

Job Description

• Design Audit and Monitoring Strategy. • Develop an annual, risk based‑ audit and monitoring strategy for all delegated provider functions. • Integrate inputs from subject matter experts, operational leaders, and monitoring data to ensure audit plans are targeted, evidence based, and aligned with organizational priorities. • Implement Audit and Monitoring Activities. • Lead, train, and align auditors and specialists to ensure consistent application of audit methodologies, tools, and strategies. • Cross-Functional Collaboration & Integration. • Partner with Delegate Performance, clinical operations, quality, compliance and other internal teams to align audit expectations with operational goals and performance initiatives. • Reporting, Insights & Continuous Improvement. • Develop clear, concise, and executive‑ready audit reports, dashboards, and summaries that highlight key risks, patterns, and performance trends across delegated entities.

Job Requirements

  • 6+ years of experience in healthcare operations, delegated oversight, provider performance management, or value-based care environments.
  • 3+ years of delegated entity oversight, process improvement, compliance, audit management, internal audit or related functions.
  • Strong understanding of delegated functions, including claims, UM, CM/CCM, appeals, and credentialing.
  • Strong knowledge of managed care principles, delivery systems, medical management processes, accreditation and regulatory standards, and delegated oversight workflows.
  • Experience collaborating cross‑functionally in matrixed healthcare organizations.
  • Bachelor's degree required in Healthcare Administration, Public Health, Business Administration, Nursing, or a related field.
  • Master’s degree preferred (e.g., MHA, MPH, MBA, MSN).

Benefits

  • Health insurance
  • 401(k) plans
  • Paid time off
  • Remote work options

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