Senior Manager, Audit Administration
Alignment Health
full-time
Posted on:
Location Type: Remote
Location: California • United States
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Salary
💰 $98,550 - $147,825 per year
Job Level
About the role
- 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.
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
audit methodologiesmonitoring strategyrisk-based auditprocess improvementcompliance managementinternal auditclaims managementutilization managementcredentialingaccreditation standards
Soft Skills
cross-functional collaborationleadershiptrainingcommunicationorganizational alignmentreportinginsight generationcontinuous improvement
Certifications
Bachelor's degreeMaster's degree