Care Management And Population Health Auditor

Clever Care Health PlanHuntington Beach, CA

Apply with Sonara

Automate your job search with Sonara.

Submit 10x as many applications with less effort than one manual application.¹

Reclaim your time by letting our AI handle the grunt work of job searching.

We continuously scan millions of openings to find your top matches.

Job Description

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We?

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members' culture and values.

Why Join Us?

We're on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you'll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

The Care Management & Population Health Auditor audits the execution of care management and population health programs, including SNP Model of Care requirements: HRA timeliness, ICP creation/updates, ICT participation, and transitions of care; tests documentation, data completeness, and outcomes tracking to ensure CMS readiness for internal departments and IPA groups.

Functions & Job Responsibilities

Conduct scheduled and ad hoc audits of MOC elements (HRA, ICP/ICT, care coordination, TOC) and maintain evidence packages for CMS review.
Perform SNPCC mock studies and file validation; partner with Population Health to close defects and sustain improvements.
Verify alignment with the MA benefit and access framework, collaborating with Clinical teams to resolve gaps that affect basic benefits under §422.101.
Support delegation oversight testing for clinical functions as required by §422.504.
Produce dashboards on HRA timeliness, ICP/ICT completion, and MOC outcome measures for Compliance and the Board.

Automate your job search with Sonara.

Submit 10x as many applications with less effort than one manual application.

Apply with Sonara Apply manually

FAQs About Care Management And Population Health Auditor Jobs at Clever Care Health Plan

What is the work location for this position at Clever Care Health Plan?

This job at Clever Care Health Plan is located in Huntington Beach, CA, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Clever Care Health Plan?

Employer has not shared pay details for this role.

What employment applies to this position at Clever Care Health Plan?

The employer has not provided this information. This may be discussed during the hiring process.

What is the process to apply for this position at Clever Care Health Plan?

You can apply for this role at Clever Care Health Plan either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.