Financial Compliance Analyst III

Job Category:  Accounting/Finance
Department:  Financial Compliance

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  10015

Salary Range:  $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)


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 in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Financial Compliance Analyst III will be responsible for the reporting, analysis and administration of Proposition 56 Tobacco Tax Funding. This position will assist in the calculation of Prop 56 directed payments using encounter data per APL guidelines. This position will be responsible for ensuring qualifying services reported using the specified Current Procedural Terminology (CPT) codes are appropriate for services rendered and reported to Department of Health Care Services (DHCS) in encounter data. The Financial Compliance Analyst III, will collaborate cross functionally with the Medical Payment System & Services (MPSS) department to ensure calculated payments will be paid accurately to our Participating Physician Group (PPG's) and specialty health plans (e.g. VSP and Beacon). This position will assist in the calculation and reconciliation of payments and also assist in the communication and follow up with rendering providers and PPG's with payment questions. Serves as a resource in support of the Financial Compliance Lead. Acts as a  Subject Matter Expert, serves as a resource and mentor for other staff.


Communication and Problem Resolution
Communication and follow up with PPG’s, rendering providers and coordinate issues with the Provider Contracting Department and MPSS.

Develop, manage and implement provider grievance process. Trouble shoot issues, assist with questions and technical assistance.

Analysis, Data and Reporting
Assist in the development of monthly, quarterly and ad hoc reports for requesting entities including but not limited to DHCS, PPGs, delegated entities, etc.
Assists with the Reconciliation reporting and analysis of Prop 56 data.
This position will also trace and track specific encounters from providers to Trans Union (data intermediary) and its submission to LAC encounters system.

Collaboration and Administration of Payments
Collaborate cross functionally with Information Technology (IT) on data file requests.
Collaborate cross functionally with MPSS, for payment process
Collaborate with Provider Network on provider issues; research and reconciliation of provider data to ensure funds are distributed appropriately.
Collaborate cross functionally with other departments as needed.

Review and analysis of all Prop 56 initiative and APL’s. Responsible for ensuring and communicating delegated entities and subcontractors comply with all applicable state and federal laws and regulations, contract requirements, and other DHCS guidance.

Follow up, track and Administration Payment requests from PPG’s.
Communicate, follow up and validate to ensure PPG’s have disbursed Prop 56 funds accordingly.

Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship,

and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable  meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.

Perform other duties as assigned.


Duties Continued

Education Required

Bachelor's Degree in Accounting or Related Field
In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Bachelor's Degree in Business Administration or Computer Science


Minimum 5 years as a financial analyst or similar data analytical field.


Experience in the Healthcare/Managed Care


Proficiency in MS SQL, Excel, Access.

Ability to compose, reconcile and present financial data using detailed reports, charts etc.

Demonstrated logical, critical and strategic thinking.

Ability to collaborate and work cross functionally within a matrix environment.

Knowledge of Managed Care Regulations.

Experience in sales and negotiations.

Excellent written, verbal communication and presentation skills.

Familiarity with Finance processes and databases.

Ability to perform complex queries with knowledge of Encounter Data.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements


Additional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.  The range is subject to change.


L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)


Nearest Major Market: Los Angeles

Job Segment: Financial Analyst, Financial, Finance