Program Assurance Auditor

Job Description

Job Description

Program Assurance Auditor

Department/Care Stream: Compliance

LIA Reporting Structure

Timecard Approver: Director of Accreditation and Program Assurance

Primary: Director of Accreditation and Program Assurance

Secondary: VP of Compliance and Risk Management

Status: Full-Time

FLSA: Exempt

Location: Admin Center

Pay Range: $95,680-$108,500/yr

EEO-1: Professional

Organization Information

WellSpace's mission is, "Achieving regional health through high quality comprehensive care." We believe that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. At WellSpace, we see you!

We are driven to serve the whole person through comprehensive, integrated care, spanning medical, dental, behavioral health, and supportive services across the region. We do this by building a team of exceptional colleagues who are dedicated to our mission and becoming part of the communities we serve.

As the region's largest Community Health System, WellSpace utilizes a Confluence Model to integrate an internal network of healthcare modalities, including Federally Qualified Health Centers (FQHC), Certified Community Behavioral Health Center (CCBHC), Drug Medi-Cal and Specialty Mental Health programs, California's second largest 988 Suicide and Crisis Lifeline Center, an independent Risk Bearing Organization (WellSpace Nexus), and more into a seamless confluence of care.

To ensure the highest quality of care, WellSpace is accredited by the Joint Commission for Ambulatory Care, Behavioral Health and as a CCBHC. Further, it is certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home. WellSpace's crisis programs are accredited by the American Association of Suicidology and the International Council for Helplines.

Position Summary

This is a full-time, in-person position. The Program Assurance Auditor supports the Compliance Department by conducting internal audits, assessments, and monitoring activities to evaluate operational performance, contractual obligations, regulatory compliance, and internal controls. Reporting to the Director of Accreditation and Program Assurance, this position independently conducts assigned audits using established methodologies, documents findings, validates corrective actions, and identifies opportunities for improvement.

A primary responsibility is evaluating performance related to county, governmental, payer, grant-funded, and other organizational agreements by assessing compliance with contractual deliverables, reporting obligations, and performance expectations. The position also conducts audits of other priorities identified through the annual Compliance Audit Plan.

Success in this role requires strong analytical skills, sound judgment, attention to detail, professional integrity, and the ability to communicate objective findings while fostering collaborative relationships across the organization.

Required Qualifications

• Bachelor’s degree in Business, Public Administration, or a related field preferred OR a combination of education and five (5) + years of progressively responsible experience in healthcare compliance, auditing, quality improvement, regulatory oversight, healthcare operations, or related field.
• Experience conducting audits, compliance reviews, monitoring activities, or operational assessments preferred.
• AHC Certified Healthcare Auditor (AHC) certification preferred. Employees who are not certified at the time of hire must obtain certification within twelve (12) months of employment.
• Working knowledge of healthcare regulations, accreditation standards, contractual requirements, and auditing principles.
• Strong Analytical, critical thinking, investigative, and problem-solving skills.
• Excellent Professional-level written and verbal communication skills.
• Proficiency with Microsoft Office applications and compliance or audit-related systems.
• Ability to independently manage multiple priorities with accuracy, objectivity, and attention to detail.
• Demonstrated professionalism, integrity, discretion, and sound judgment.
• Maintains required licenses and certifications in good standing.
• High level of integrity and discretion in handling confidential and sensitive information.
• Exceptional organizational and time management skills.
• Exceptional interpersonal and collaboration skills across departments and levels.
• Ability to prepare clear, objective audit reports and communicate findings effectively.
• Ability to travel up to 20% as required.
• Commitment to HIPAA and professional ethics.
• Adherence to infection control procedures and High Reliability standards.

Essential Responsibilities

Internal Auditing & Monitoring

• Conduct assigned internal audits, assessments, and monitoring activities using established audit methodologies.
• Evaluate compliance with federal, state, local, payer, accreditation, contractual, and organizational requirements.
• Assess operational performance, internal controls, documentation, and adherence to organizational policies and procedures.
• Identify compliance gaps, control weaknesses, and opportunities for operational improvement.
• Conduct follow-up reviews to validate implementation and effectiveness of corrective actions.

Performance & Contract Compliance

• Evaluate organizational performance related to county, governmental, payer, grant-funded, and other organizational agreements.
• Assess compliance with contractual deliverables, reporting requirements, quality measures, and performance expectations.
• Evaluate processes supporting contract oversight and identify opportunities to strengthen compliance, accountability, and performance.
• Assess whether contractual obligations are being fulfilled by all applicable parties and communicate observations to Compliance leadership.

Audit Readiness & Regulatory Compliance

• Conduct audit readiness reviews for regulatory agencies, payers, accreditation organizations, and other external oversight entities.
• Review external audit findings and monitor corrective action implementation to support sustained compliance.
• Assist with special reviews, investigations, and focused compliance assessments as assigned.

Analysis & Reporting

• Collect, analyze, and validate audit evidence, documentation, performance data, and supporting records.
• Prepare objective audit workpapers, reports, summaries, and recommendations.
• Communicate audit findings and improvement opportunities to the Compliance Manager and operational leadership.
• Maintain accurate audit documentation in accordance with departmental standards.

Collaboration & Professional Responsibilities

• Collaborate with operational departments to facilitate audits and promote continuous compliance and performance improvement while maintaining auditor independence.
• Maintain current knowledge of applicable laws, regulations, accreditation standards, contractual requirements, and auditing practices.
• Participate in departmental meetings, training, and professional development activities.
• Perform other related duties as assigned.

Benefits

Successful candidate will receive regionally competitive salary, above average health benefits at reduced costs, company paid life insurance & long-term disability insurance, additional voluntary retirement plan with company match and no vesting schedule requirement.

• Paid bereavement and jury duty leave
• 11 paid holidays per year
• Paid time off
• Paid sick leave
• Flexible Spending Program
• Company paid malpractice insurance for all providers
• Professional development hours offered annually

Physical Demands and Work Environment

The work environment is characteristic of an office clinic environment. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is frequently required to sit; use hands and arms to reach. The employee is also required to stand; walk; and reach with hands and arms. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus. The employee must also possess hearing and speech to communicate in person and over the phone. The noise level in the work environment is usually quiet.

The employee may be in contact with individuals and families in crisis who may be ill, using substances and/or not attentive to personal health and safety for themselves or their homes. The employee may experience a number of unpleasant sensory demands associated with the client’s use of alcohol and drugs, and the lack of personal care. The employee may also be exposed to bodily fluids (blood, urine) and hazardous chemicals.

WellSpace Health is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is the intent of WellSpace Health to maintain a work environment free of harassment, discrimination, or retaliation because of age, race, religious creed, color, national origin, ancestry, physical disability, medical condition, genetic information, marital status, sex (including pregnancy, childbirth, breastfeeding and/or related medical conditions), gender, gender identity, gender expression, sexual orientation, military or veteran status, or any other status protected by federal, state or local laws. WellSpace Health is dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WellSpace Health is an Equal Opportunity Employer

Company Description

WellSpace's mission is "achieving regional health through high quality comprehensive care." We believe that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. At WellSpace, we see you!

We are driven to serve the whole person through comprehensive, integrated care, spanning medical, dental, behavioral health, and supportive services across the region. We do this by building a team of exceptional colleagues who are dedicated to our mission and becoming part of the communities we serve.

As the region's largest Community Health System, WellSpace utilizes a Confluence Model to integrate an internal network of healthcare modalities, including Federally Qualified Health Centers (FQHC), Certified Community Behavioral Health Center (CCBHC), Drug Medi-Cal and Specialty Mental Health programs, California's second largest 988 Suicide and Crisis Lifeline Center, an independent Risk Bearing Organization (WellSpace Nexus), and more into a seamless confluence of care.

To ensure the highest quality of care, WellSpace is accredited by the Joint Commission for Ambulatory Care, Behavioral Health and as a CCBHC. Further, it is certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home. WellSpace's crisis programs are accredited by the American Association of Suicidology and the International Council for Helplines.

Company Description

WellSpace's mission is "achieving regional health through high quality comprehensive care." We believe that everyone deserves to be seen, no matter who you are, where you come from, where you work or what place you call home. At WellSpace, we see you! \r\rWe are driven to serve the whole person through comprehensive, integrated care, spanning medical, dental, behavioral health, and supportive services across the region. We do this by building a team of exceptional colleagues who are dedicated to our mission and becoming part of the communities we serve. \r\rAs the region's largest Community Health System, WellSpace utilizes a Confluence Model to integrate an internal network of healthcare modalities, including Federally Qualified Health Centers (FQHC), Certified Community Behavioral Health Center (CCBHC), Drug Medi-Cal and Specialty Mental Health programs, California's second largest 988 Suicide and Crisis Lifeline Center, an independent Risk Bearing Organization (WellSpace Nexus), and more into a seamless confluence of care. \r\rTo ensure the highest quality of care, WellSpace is accredited by the Joint Commission for Ambulatory Care, Behavioral Health and as a CCBHC. Further, it is certified by the Joint Commission as a Primary Care Medical Home and a Behavioral Health Home. WellSpace's crisis programs are accredited by the American Association of Suicidology and the International Council for Helplines.