Virtual Audit Jobs in Rialto, CA (NOW HIRING)

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!

The Transportation Network Representative serves as the frontline field role and primary point of contact for transportation providers and facilities. This position is responsible for provider coaching, training, onboarding, and enforcing performance standards to ensure service quality and compliance. Key responsibilities include executing audits and inspections, coordinating facility liaison activities, and managing scheduling and trip-level triage to maintain timely and accurate transportation services. The role also involves conducting member and provider outreach, preparing accounts payable evidence packages, maintaining thorough documentation, and supporting Voice of Member initiatives to enhance the overall experience. Success in this position requires strong organizational skills, attention to detail, and the ability to build effective relationships with providers and facilities to uphold compliance and deliver exceptional member care.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account - Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Education & Requirement

• Three plus (3+) years of experience in a combination of transportation operations, provider relations, and/or healthcare network coordination
• Experience training and onboarding providers on operational processes and compliance standards
• Field-based work experience with clear policy communication skills
• Preferred experience in the following areas:
  • Experience supporting managed care claims, encounters, and billing dispute resolution
  • Background in high-volume, operationally complex environments with multiple vendor relationships
  • Contribution to Voice of Member (VoM) or Customer Experience (CX) initiatives, including accurate tagging, issue categorization, and supporting closed-loop improvements
• High School Diploma or GED required 
  • Associate's degree in Healthcare Administration, Business Administration, or a related field from an accredited institution preferred
  • Passenger Assistance, Safety and Sensitivity (PASS) Certification from the Community Transportation Association of America (CTAA) preferred
• Must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points

Key Qualifications 

• Knowledge and understanding in the following areas:
  • NEMTAC standards and competency guidelines
  • Healthcare compliance standards, including CMS, DHCS, DMHC, and Medi-Cal transportation benefit regulations
  • Provider performance management frameworks, including scorecards and action improvement plans
  • Dispatch optimization principles and trip assignment best practices
  • Standard operating procedures for Standing Orders (STO), PCS forms, and credentialing enforcement
  • Basic principles of billing integrity and fraud detection protocols
  • Strong understanding of transportation workflows and the impact of missed or delayed trips on member experience
  • Familiarity with IEHP transportation policy, Medi-Cal regulations, and NEMT authorization processes preferred
  • Intermediate proficiency in Microsoft Excel (pivot tables, VLOOKUP) and Word (policy documentation)
  • Ability to run and interpret trip-level and provider performance reports
  • Familiarity with scheduling and dispatch platforms for trip assignment optimization
  • Competence in using data analysis tools for KPI tracking and VoM analytics
  • Basic knowledge of AP processes and assembling billing evidence packages
  • Familiarity with provider portals and/or dispatching software
  • Strong analytical and documentation skills for audits, billing investigations, and compliance
  • Strong communication skills for policy interpretation and provider coaching
  • Ability to build effective relationships with providers, facilities, and internal teams
  • Problem-solving skills to resolve trip-level issues and operational challenges under time constraints
  • High adaptability and organizational skills for managing multiple priorities in a fast-paced environment
  • Attention to detail to ensure accurate documentation and compliance readiness
  • Proven ability to collaborate with cross-functional teams, including AP, Finance, and Operations

Start your journey towards a thriving future with IEHP and apply TODAY!

• This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA.)

• This position is primarily office-based and involves frequent virtual meetings and collaboration with internal departments and external vendors. Occasional travel within the service region and to vendor sites is required, which may include travel outside of normal business hours for urgent operational needs or regulatory audits. Additionally, the role may require extended hours during peak periods, audits, or when addressing escalated issues.