The Customer Solution Center Audit Readiness Specialist II is responsible for the execution, oversight, and monitoring of the guidelines and protocols to ensure readiness for all regulatory audits.
This position will develop, with the assistance of CSC management, a successful auditing strategy for the following end-to-end processes within CSC (i.e. Enrollment processing timeliness and accuracy of loading members, timeliness of I.D. Card and member materials, outbound health risk assessment (HRA) calls for Seniors and People with Disabilities (SPD) and Cal MediConnect (CMC) plus HIF for Medi-Cal Direct program (MCLA), call documentation and categorization, service authorization request and coverage determination, Appeals and Grievances across all lines of business).
This position is responsible for the ongoing progression and maintenance of CSC's compliance program efforts, including, but not limit...