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Model Audit Jobs in California (NOW HIRING)

Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness,andencounter data integrity. * Partner with compliance, legal ...

Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness, and encounter data integrity. * Partner with compliance, legal ...

AVP, Internal Audit

San Diego, CA · On-site

$85K - $140K/yr

This role is a key driver of technology-forward audit innovation, helping Axos Bank harness AI, data modeling, and advanced analytics to elevate audit quality and efficiency. This role partners ...

This role is a key driver of technology-forward audit innovation, helping Axos Bank harness AI, data modeling, and advanced analytics to elevate audit quality and efficiency. This role partners ...

Audit Supervisor

Costa Mesa, CA · On-site

$75K - $130K/yr

The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...

Audit Supervisor

Costa Mesa, CA · On-site

$75K - $130K/yr

The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...

Audit Director Summary: Our client is a full service public accounting firm that has embraced ... Understand the firm's financial model and ensure profitable delivery of engagements. * Expand ...

Audit Manager

Redwood City, CA · On-site

$120K - $157K/yr

Audit Manager Advance your career with us and be a part of a five-decade legacy of working with the ... Act as a role model and mentor to new and existing staff by creating a positive work environment ...

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Model Audit information

What are some common challenges faced by professionals in Model Audit roles, and how can they effectively address them?

Professionals in Model Audit roles often encounter challenges such as navigating complex quantitative models, understanding evolving regulatory requirements, and communicating technical findings to non-technical stakeholders. To address these, it's important to maintain strong analytical skills, stay updated on industry regulations, and develop clear documentation and presentation abilities. Collaborative work with model developers, risk managers, and compliance teams is also essential to ensure a comprehensive and effective audit process.

What are model audit jobs?

Model audit jobs involve reviewing and validating financial, statistical, or mathematical models used by organizations to ensure their accuracy, reliability, and compliance with regulations. Professionals in this field assess model assumptions, data inputs, methodologies, and documentation to identify potential risks or errors. Model auditors often work in industries such as banking, insurance, and consulting, where robust models are critical for decision-making and risk management. Their work helps organizations maintain trust with stakeholders and regulatory bodies.

What is the difference between Model Audit vs Data Analyst?

AspectModel AuditData Analyst
Required CredentialsCertifications in auditing, data science, or analyticsDegree in statistics, data science, or related field
Work EnvironmentFinancial institutions, tech companies, consulting firmsBusiness, finance, healthcare, marketing sectors
Employer & Industry UsageUsed to ensure model compliance and accuracyUsed to interpret data and generate reports

Model Audits focus on evaluating the accuracy, compliance, and robustness of predictive models, often within financial or tech industries. Data Analysts interpret and visualize data to support decision-making. While both roles require analytical skills and familiarity with data tools, Model Auditors emphasize validation and regulatory compliance, whereas Data Analysts focus on data interpretation and reporting.

What are the key skills and qualifications needed to thrive as a Model Auditor, and why are they important?

To thrive as a Model Auditor, you need a solid background in quantitative analysis, risk management, and statistical modeling, often supported by a degree in mathematics, finance, or a related field. Familiarity with programming languages like Python or R, model validation frameworks, and regulatory standards such as SR 11-7 or IFRS 9 is typically required. Strong attention to detail, critical thinking, and effective communication skills help in assessing complex models and conveying findings to stakeholders. These skills ensure that financial and risk models are robust, compliant, and transparent, reducing organizational risk and supporting decision-making.
What job categories do people searching Model Audit jobs in California look for? The top searched job categories for Model Audit jobs in California are:
What cities in California are hiring for Model Audit jobs? Cities in California with the most Model Audit job openings:
VP, Internal Audit

Full-time

Posted 13 days ago


Alignment Healthcare rating

7.3

Company rating: 7.3 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

232nd of 298 rated insurance


Job description

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The VP, Internal Audit is a highly visible senior leadership role responsible for directing the internal audit function at Alignment Healthcare, Inc., with accountability for SOX compliance, enterprise risk management, and regulatory oversight across all business operations. This leader works in close partnership with the Audit Committee, CFO, CAO, executive leadership, legal, compliance, finance, and business unit leaders to strengthen the overall control environment and position internal audit as a trusted advisor-not merely a compliance function. Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces emerging risks, and ensures the organization operates with the highest standards of accountability. This is a critical enterprise function whose outcomes directly protect patients, maintain regulatory standing, and support the organization's mission of delivering high-quality, cost-effective care to Medicare Advantage-enrolled seniors.

Job Profile Summary

The VP, Internal Audit is a highly visible senior leadership role responsible for directing the internal audit functionat Alignment Healthcare, Inc., with accountability for SOX compliance, enterprise risk management, and regulatory oversight across all business operations. This leader works in close partnership with the Audit Committee, CFO,CAO,executive leadership, legal, compliance, finance, and business unit leaders to strengthen the overall control environment and position internal audit as a trusted advisor-not merely a compliance function. Drawing on deepexpertisein Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces emerging risks, and ensures the organizationoperateswith the highest standards of accountability. This is a critical enterprise function whose outcomes directly protect patients,maintainregulatory standing, and support the organization's mission of delivering high-quality, cost-effective care to MedicareAdvantage-enrolled seniors.

Job Duties / Responsibilities

SOX Program Leadership & Internal Control Governance

  • Lead the design, execution, and continuous improvement of the company's SOX 404 program, including scoping, risk assessment, control design, testing, and documentation.

  • Drive governance over the outsourcedinternalaudit partner, holding them accountable for quality, timelines, and professional standards.

  • Ensureall SOX documentation and testing results are complete,accurate, and maintainedin accordance withPCAOB standards and internal policy.

Enterprise Risk Assessment("ERM")& Audit Planning

  • Overseesthe Company's ERM processbydevelopingandexecutinga risk-based annual audit plan that provides comprehensive coverage of financial, operational, IT, and regulatory risks across the organization.

  • Proactivelyidentifycontrolenvironment gaps and emerging risks before theyescalate, andcommunicate findings with timeliness and transparency to senior management and the Audit Committeewhen needed.

Medicare Advantage Regulatory Compliance Oversight

  • Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness,andencounter data integrity.

  • Partner with compliance, legal, and actuarial leaders to ensure audit programs reflect current CMS regulations.

Control Deficiency Remediation & Management Accountability

  • Oversee the identification of root causes behind control failures,monitorremediation efforts, and hold management accountable fortimelyand durable resolution of deficiencies.

  • Deliver regular, clear status updates to executive leadership and the Audit Committee-translating complex audit findings into actionable business intelligence.

Operational Audit Leadership

  • Lead operational audits across all functional areas-finance, HR, claims, medical management, pharmacy, andtechnology-applyinga consistent, risk-basedmethodologyto evaluate process integrity andidentifyefficiency opportunities.

  • This includes overseeing IT general controls (ITGCs) and system-level controls related to ERP, claims, and data migration initiatives.

Control Culture & Business Partnership

  • Embed a culture of accountability by serving as a trusted advisor to business leaders on effective control design, helping them understand what "good" looks like in practice.

  • Move the organization from a compliance-driven mindset toone ofownership, where controls are embedded in daily operations rather than layered as an after-thought.

Audit Committee Engagement & Executive Reporting

  • Serve as the primary liaison to the Audit Committee Chair, providing regular reporting on audit results, risk exposure, program quality, and remediation progress.

  • Apply strong executive presence and communication skills to translate audit data into strategic insights for the Board and senior leadership.

Supervisory Responsibilities

This role carries supervisory responsibility over theCompany's third-party external audit team, including oversight of quality, work standards, timelines, reporting, and cost management.

Supervisory Requirements: Fulfill supervisory responsibilities in accordance with organization policies and applicable laws.Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Job Requirements

Experience

Required:

  • 15+ years of progressive internal audit, external audit, or financial controls experience, with at least 5 years in a senior leadership role

  • 8+ years of experience with a publicly traded company, including demonstrated knowledge of SEC reporting requirements and PCAOB auditing standards

  • Deepexpertisein Medicare Advantage plans, risk adjustment, and healthcare operations, including familiarity with CMS regulations, RADV, and the Model Audit Rule

  • Experience leading audit work in complex, regulatedhealthcareor insurance environments with strong emphasis on SOX and COSO framework application

  • Demonstrated experience directing and governing outsourced or co-sourced audit partnerships, including vendor management and quality oversight

Preferred:

  • Experience supporting Audit Committee reporting and direct interaction with Board-level governance bodies

  • Prior experience at a Big 4 public accounting firm or national advisory firm within a healthcare or managed care practice

  • Exposure to ERP implementation controls, data migration audits, and IT general controls in a healthcare setting

Education

Required:

  • Bachelor's degree in Accounting, Finance, Business Administration, or a closely related field

Preferred:

  • Master's degree in Accounting, Business Administration (MBA), or Healthcare Administration

  • Graduate coursework or certification in risk management, internal auditing, or healthcare compliance

Training

Required:

  • Ongoing professional development in internal auditing standards, including IIA (Institute of Internal Auditors) standards and the COSO Internal Control Integrated Framework

  • Demonstrated working knowledge of PCAOB standards, SEC reporting requirements, and SOX Section 404 implementation

Preferred:

  • Training in Medicare Advantageregulatory compliance, including CMS audit readiness, RADV methodologies, and encounter data management

  • Coursework or training in enterprise risk management frameworks (e.g., COSO ERM, ISO 31000)

  • Data analytics and audit technology training (e.g., ACL/Galvanize,TeamMate, or similar audit management tools)

Skills & Competencies

Technical / Role-Specific Skills

  • SOX 404 Program Management (Advanced):Demonstratedmastery of scoping, risk assessment, control design, testingmethodology, and PCAOB-compliant documentation across financial and IT controls

  • Medicare Advantage & Healthcare Regulatory Compliance (Advanced): In-depth knowledge of CMS regulations, risk adjustmentmethodology, RADV audit processes, encounter data integrity, and the Model Audit Rule as they apply to Medicare Advantage health plans

  • Enterprise Risk Management (Advanced): Ability to design and execute risk-based audit plans that address financial, operational, IT, and regulatory risks across complex, multi-functional organizations; fluency with COSO ERM framework

  • IT General Controls & Systems Audit (Intermediate to Advanced): Working knowledge of IT general controls, ERP control environments, data migration oversight, and systems implementation auditing-particularly in claims, pharmacy, and financial systems

  • Audit Committee & Executive Communication (Advanced): Exceptional written and verbal communication skills; ability to translate complex audit findings into concise, strategic narratives for Board-level and C-suite audiences whilemaintainingfull independence from management decision-making

  • Remediation Management & Root Cause Analysis (Advanced): Systematic approach toidentifyingroot causes of control breakdowns, designing corrective action plans, and driving sustainable resolution with measurable outcomes

  • Data-Driven Audit Analytics (Intermediate): Familiarity with audit analytics tools (e.g., ACL, IDEA, Tableau, or similar) to enhance audit coverage,identifyanomalies, and improve audit efficiency across large data sets common in healthcare and claims environments.

Licensure

Required:

  • No specific licensure is mandated; however, active professional standing in a recognized auditing or accounting credential is strongly expected at this level

Preferred:

  • Certified Public Accountant (CPA) - strongly preferred;indicatestechnical grounding in financial reporting, accounting standards, and attestation

  • Certified Internal Auditor (CIA) -preferred; the global standard for internal audit professionals,demonstratingproficiencyin IIA Standards, risk management, and governance

  • Certified Information Systems Auditor (CISA) -preferred, particularly given the IT controls and ERP oversight responsibilities of this role

Essential Physical Functions:

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.Reasonableaccommodationsmay be made to enable individuals with disabilities to perform the essential functions.

  • While performing the duties of this job, the employeeis regularly required totalk or hear. The employee regularlyis required tostand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

  • The employeefrequentlylifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwiseparticipatingin the employee selection process, please contactcareers@ahcusa.com.

Pay Range: $227,952.00 - $341,928.00

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related ...


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