Job summary
Job post source
This job is from a recruiting firm hiring for a separate company based on the contract nature and pay rate details.
Job overview
The Sr. Health Plan Auditor role involves planning, executing, and monitoring audits to ensure compliance with financial solvency and claims processing regulations in specialty health plans, impacting regulatory adherence and operational integrity.
Responsibilities and impact
The auditor will conduct audits of financial solvency and claims compliance, manage DMHC claims data submissions quarterly and annually, create and review departmental policies, and mentor other staff members.
Compensation and benefits
The position offers an hourly pay rate between $50.53 and $55.53 for a 13-week contract with possible extension, with remote work and one onsite day per month in Los Angeles, CA.
Experience and skills
Candidates must have at least 3 years of financial audit experience, 5 years in managed health care, 2 years in accounting, and hold certifications such as CPA, CMA, CIA, CFE, or CISA.
Work environment and culture
The role is remote with minimal onsite presence, suggesting a flexible work environment with emphasis on compliance and mentorship.
Job location and travel
The job is remote with one day onsite per month in Los Angeles, CA 90017.
Unique job features
This is a contract role focused on specialty health plan audits with regulatory compliance and policy development responsibilities.
Company overview
Excelon Solutions is a global IT services and consulting company specializing in digital transformation, cloud computing, and data analytics. They generate revenue by offering customized technology solutions, managed services, and strategic consulting to enterprises across various industries. Founded in 2005, Excelon has grown rapidly, establishing a strong presence in North America, Europe, and Asia. Key milestones include partnerships with major tech firms like Microsoft and AWS, and recognition in industry rankings for innovation and customer satisfaction.
How to land this job
Position your resume to emphasize your expertise in financial audits within the managed health care industry, highlighting your experience with specialty health plans and vendor compliance.
Focus on showcasing your knowledge of regulatory requirements, claims processing compliance, and your ability to develop and monitor corrective action plans, as these are key responsibilities for the Senior Health Plan Auditor role.
Apply through multiple platforms including Excelon Solutions' corporate website and LinkedIn to maximize your application visibility and chances of being noticed.
Connect on LinkedIn with professionals working in Excelon Solutions' audit or managed care divisions; use ice breakers like asking about recent changes in DMHC claims data submissions or inquiring about best practices for audit policy development.
Optimize your resume for ATS by incorporating keywords from the job description such as 'financial audits,' 'managed health care,' 'claims processing compliance,' 'DMHC claims data,' and your relevant certifications like CPA or CIA to ensure your resume passes initial screenings.
Utilize Jennie Johnson's Power Apply feature to automate tailored applications, identify multiple application channels, and find LinkedIn contacts for networking, allowing you to focus your energy on interview preparation and skill enhancement.
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