Utilization Management Quality Reporting and Auditing Specialist I Join to apply for the Utilization Management Quality Reporting and Auditing Specialist I role at L.A. Care Health Plan
Salary: $60,778 – $75,950 – $91,166
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low‑income Los Angeles County residents. We are the nation’s largest publicly operated health plan, serving more than 2 million members and ensuring our members get the right care at the right place at the right time.
Job Summary The Utilization Management (UM) Quality Reporting and Auditing Specialist I is responsible for working with the quality team and UM Leadership to support effective implementation of reporting and auditing work plans and projects.
Duties Complete quality projects related to reporting, auditing, preparation and execution of external and internal audits.
Support UM department with routine reporting and auditing/quality activities and work plans.
Manage administrative activities related to reporting, compliance, and quality projects in the UM department.
Plan and organize collaboratively and cross‑departmental meetings to problem‑solve, document issues and validate activities or reports.
Provide education to staff based on audit findings, including updating job aids and demonstrating compliant processes.
Apply knowledge of federal and state requirements/standards to ensure compliance for reporting and auditing.
Perform other duties as assigned.
Education Associate’s Degree (or equivalent education and/or experience).
Preferred: Bachelor’s Degree in Business Administration or related field.
Experience At least 2 years of experience in a healthcare quality or quality/compliance role.
Experience navigating an EMR/system.
Experience in using analytical skills related to reporting and data processing.
Skills Ability to work under pressure with multiple deadlines.
Excellent verbal and written communication skills.
Ability to develop reports and documents on an as‑needed basis.
Strong Microsoft Excel knowledge and skills.
Knowledge of federal and state requirements and standards related to reporting and auditing.
Physical Requirements Light
Benefits Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)