Audit Manager - Client Services

Account Management & Client Services San Diego, California


Description

American Specialty Health Incorporated is seeking an experienced Client Audit Manager to join our Client Services – Clinical department. This position will provide support for client delegation (including pre-delegation) and regulatory compliance audits.  The position also supports other delegation oversight compliance efforts, as well compliance-related inquiries/reviews, in consultation with the Sr. Manager, Delegation Support and Director, Clinical Client Services.  The position also supports other compliance activities of the department related to internal compliance efforts.

 

Responsibilities

  • Provides support related to complex delegation support activities in consultation with and under the direction of Sr. Manager, Delegation Support.
  • Leads audits on behalf of ASH with assigned clients.
  • Facilitates and leads internal and external meetings acting as owner of information.  This includes creating and distributing meeting agendas, kicking off the discussion with a high-level overview and purpose of the meeting, introductions, and then closing the discussion with action items.  This also includes facilitating and leading any internal preparation meetings and/or sending out details to the internal stakeholders prior to the meeting so they have enough information to prepare for their role in the discussion.
  • Proactively engages internal customers and subject matter experts to effectively manage internal and external customer expectations.
  • Seeks support from and provides client updates at internal committee meetings as appropriate.
  • Travels, as directed by the Sr. Manager, Delegation Support, to support audits in locations other than the position’s designated ASH office location.
  • Provides support for internal compliance activities, as needed, based on direction from Sr. Manager, Delegation Support.
  • Actively participates in collaborative team environment to educate, coordinate activities, and resolve unique problems with recommended courses of action to internal stakeholders.
  • Accepts and/or returns phone calls from clients within the same business day of receipt, Monday through Friday.
  • At a minimum, acknowledges receipt of emails from clients within 24 hours of receipt.
  • Maintains timely and accurate documentation of client interactions, activities, processes and issue resolution; ensures meeting minutes and action items are prepared and documented within two days of a client meeting as applicable.
  • Ensures high level of service to meet client expectations on a daily basis.
  • Communicates with Sr. Manager Delegation Support and Director, CTC, on high level issues to ensure appropriate response and resolution.
  • Establishes and maintains positive professional relationships with internal and external customers.
  • Interfaces with ASH staff to resolve issues, answer questions and triage responses.
  • Schedules internal and external meetings to support audit initiatives as applicable. 
  • Acts as a back-up for other Delegation Support Managers.
  • Maintains compliance with ASH policies and procedures.
  • Seeks support and training from designated Delegation Support Manager II, Senior Delegation Support Manager, and/or Director, Client Services to aide in gaining the experience and skills required to advance to a Delegation Support Manager II.
  • Maintains confidentiality of all reports, files, schedules, databases, and documents; as well as all member, provider, and proprietary information and ensures the Delegation Support team does the same.
  • At the direction of the Sr. Manager, Delegation Support, communicates unique aspects of client delegation activities at various meetings with internal and external customers to support delegation functions.
  • At the direction of the Sr. Manager, Delegation Support participates in activities related to internal and external process improvements.
  • Manages compliance attestation requests from clients requiring Compliance Office signature, including keeping the Compliance Office informed of attestation requests and working with department staff and internal stakeholders to monitor and track requirements set forth in attestations, particularly new requests and requests not previously specified via contract with clients.

Qualifications

  • Bachelor’s degree in in related field or equivalent experience.  If equivalent experience, high school diploma required.
  • Proficiency in MS Office with intermediate experience in Word, Outlook and Excel required. 
  • Experience in health care administration preferred but not required. 
  • Experience in managed care operations preferred but not required.  Experience may include accreditation, account management, regulatory compliance, contract review,
  • Proven experience and developed Customer Service skills required.
  • Experience in project management, meeting facilitation and documentation required.
  • Training or certification in health care beneficial but not required.

Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects.  Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard.  Ability to lift up to 10 lbs.

Environmental Conditions

Usual office setting.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information.