Internal Audit Management LVN at LSMA Management Inc

San Bernardino, California, United States -

Full Time

Start Date

Immediate

Expiry Date

16 Jun, 26

Salary

40.0

Posted On

18 Mar, 26

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Delegation Oversight, Medical Management, Utilization Management, Quality Management, Audit Preparation, Corrective Action Follow-up, Reporting Governance, Compliance Standards, Attention To Detail, Medical Terminology, Stakeholder Support, Microsoft Excel, Reporting Tools, HEDIS, SQL, BI

Industry

Health and Human Services

Description

Description JOB SUMMARY The Internal Audit Management LVN supports the oversight and monitoring of delegated functions of contracted medical groups to ensure regulatory, accreditation, and health plan compliance. This role assists with audit preparation, internal reviews, corrective action follow-up, reporting governance, letter accuracy, and process standardization. The LVN collaborates with Medical Management leadership, IT, analytics, and external partners to help maintain compliant, timely, and accurate operational performance. Requirements MINIMUM & PREFERRED QUALIFICATIONS Education/Training Minimum: Graduate of an accredited Licensed Vocational Nurse program. Preferred: Coursework or training in quality management, managed care, compliance, or healthcare administration. Experience Minimum: 10+ years of experience in Delegation Oversight, Medical Management, Utilization Management, Quality Management, or related healthcare operations. Prior supervisory or leadership experience. Preferred: Experience with HEDIS or quality performance measures. Experience in system testing, change control, or IT partnership environments. Advanced experience in reporting tools (SQL/BI), Excel, or healthcare analytics. Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position. Certification(s) Current State LVN License Preferred: Certified Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM), and/or Project Management Certification (CAPM/PMP). Skills, Knowledge & Abilities · Knowledge of delegated functions, compliance standards, and health plan reporting requirements. · Strong attention to detail and accuracy in documentation and letter review. · Ability to interpret guidelines and apply them within LVN scope to operational processes. · Proficiency in medical terminology, documentation standards, and regulatory timeframes. · Strong communication, teamwork, and stakeholder support skills. · Ability to coordinate tasks and support staff without independent clinical decision-making authority. · Competence in Microsoft Excel, reporting tools, and electronic workflows. PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. This position involves prolonged computer-based work requiring frequent use of a keyboard and mouse, along with regular walking, standing, bending, and the ability to lift or move up to 25 pounds. It occasionally requires stooping, kneeling, crouching, or crawling. The role demands strong visual capability—including close, distance, color, peripheral vision, depth perception, and focus adjustment—and the ability to concentrate for extended periods while managing interruptions and meeting deadlines. Work is primarily remote but may involve travel for meetings or oversight activities.

Responsibilities

The Internal Audit Management LVN supports the oversight and monitoring of delegated functions of contracted medical groups to ensure regulatory, accreditation, and health plan compliance. This role assists with audit preparation, internal reviews, corrective action follow-up, reporting governance, letter accuracy, and process standardization.