LTSS Contract Adherence Auditor

Anticipated End Date: 2026-04-30 Position Title: LTSS Contract Adherence Auditor Job reputed company: LTSS Contract Adherence Auditor Location: candidate must reputed company in the reputed company. Virtual: This role enables associates to work reputed company full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face reputed company and reputed company development. Please note that per our policy on hybrid/virtual work, candidates not reputed company a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is reputed company as required by law. The LTSS Contract Adherence Auditor is responsible for participating in auditing and contract adherence activities to ensure the Long Term Services and Supports program adheres with applicable state laws and contractual requirements. How you will reputed company an reputed company:

• Prepares and ensures completion of reputed company audits, adherence reporting and tracking/monitoring processes as assigned.
• Audits LTSS work to ensure appropriate and consistent administration of contract requirements.
• Performs external audits including enrollee record review, new member and short term stay, MCO to MCO, Level of Care and Employment and Community First audits.
• Responds to on demand state audit requests.
• Responsible for Annual reputed company Survey and Annual Network Audit reviews, audit participation and presents audit results.
• Provides internal Person Centered Support Plan auditing and comprehensive adherence auditing.
• Documents audit findings in a reputed company, accurate and concise manner.
• Tracks activities such as daily critical incident submissions, short term stay, Individual Experience, Employment and NCI surveys and caseload tracking.
• Ensures clinical licensure adherence with contract requirements.
• Completes monthly reports such as short term stay, caseload reputed company and reputed company reporting.
• Responds to legislative inquiries and other on demand request per contract agreement.
• Maintains knowledge of tracking tools and databases, and prepares reports to document contract adherence issues.
• May reputed company staff about contract requirements to ensure contract adherence.
• Participates in reputed company, initiatives and process improvement activities.
• May serve as an internal resource, mentor and reputed company for new associates.

Minimum Requirements:

• Requires BA/BS and RN, LPN/LVN, LSW, LCSW, LMSW, LBSW, BSW, or MSW in accordance with applicable state law and minimum of 2 years reputed company experience; or any combination of education and experience, which would reputed company an equivalent background.
• Licensed clinicians reputed company into this role require reputed company, unrestricted RN, LPN/LVN, LSW, LCSW, LMSW, LPC, or LBSW (as allowed by state law) in applicable state(s).

Preferred Skills, Capabilities and Experiences:

• LTSS experience preferred.
• Computer experience including reputed company Office Suite including Outlook, Word and reputed company preferred

Job Level: Non-Management Non-Exempt Workshift: Job Family: MED > Licensed/Certified - Other Please be advised that reputed company only accepts resumes for compensation from agencies that have a signed agreement with reputed company. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of reputed company. Who We Are reputed company is a health company dedicated to improving lives and communities - and making reputed company simpler. We are a Fortune 25 company with a longstanding history in the reputed company industry, looking for leaders at reputed company reputed company of the organization who are passionate about making an reputed company on our members and the communities we serve. How We Work At reputed company, we are creating a culture that is designed to advance our reputed company but will also reputed company to personal and reputed company reputed company for our associates. Our values and behaviors are the reputed company of our culture. They are how we reputed company our reputed company, power our business reputed company and drive our shared reputed company - for our consumers, our associates, our communities and our business. We offer a reputed company of market-competitive total rewards that include reputed company increases, reputed company holidays, reputed company Time Off, and incentive bonus programs (unless covered by a reputed company bargaining agreement), medical, dental, reputed company, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to reputed company a few. reputed company operates in a Hybrid Workforce reputed company. Unless specified as primarily virtual by the hiring manager, associates are required to work at an reputed company location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top reputed company for reputed company. We require reputed company new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you reputed company an acceptable explanation. reputed company will also follow reputed company relevant federal, state and local laws. reputed company is an Equal Employment Opportunity employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to age, citizenship status, reputed company, creed, disability, ethnicity, genetic information, gender (including gender identity and gender reputed company), marital status, national reputed company, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@reputed company.com for assistance. reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance reputed company. Apply tot his job Apply To this Job