Internal Audit Management LVN

LSMA Management Inc • San Bernardino, CA

4d • Remote

About The Position

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

• Graduate of an accredited Licensed Vocational Nurse program.
• 10+ years of experience in Delegation Oversight, Medical Management, Utilization Management, Quality Management, or related healthcare operations.
• Prior supervisory or leadership experience.
• Current State LVN License
• 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.

Nice To Haves

• Coursework or training in quality management, managed care, compliance, or healthcare administration.
• 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.
• Certified Professional in Healthcare Quality (CPHQ), Certified Case Manager (CCM), and/or Project Management Certification (CAPM/PMP).

Responsibilities

• Supports the oversight and monitoring of delegated functions of contracted medical groups
• Assists with audit preparation
• Assists with internal reviews
• Assists with corrective action follow-up
• Assists with reporting governance
• Assists with letter accuracy
• Assists with process standardization
• Collaborates with Medical Management leadership, IT, analytics, and external partners

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed