Jared Smith
Healthcare Compliance & Risk Professional| Medicare, Medicaid, & Commercial Plans | Regulatory Oversight & Audit Leadership
- Role
- Oversight Program Auditor at Elevance Health
- Location
- Los Angeles, CA, US
- LinkedIn followers
- 500 followers
About Jared Smith
Healthcare Compliance & Delegation Oversight Professional | Regulatory Risk Mitigation | CMS, DHCS, DMHC, NCQA I am a healthcare compliance professional with over 12 years of experience in regulatory oversight, auditing, and risk mitigation across Medicare, Medi-Cal/Medicaid, and Commercial health plans. I specialize in conducting complex compliance audits, evaluating delegated entities, and driving corrective action initiatives that strengthen organizational compliance and operational integrity.At CenCal Health, I support the Audits, Monitoring & Oversight (AMO) program by conducting regulatory audits, developing audit tools and scopes, performing risk analyses, and contributing to the Delegation Oversight Committee through reporting, findings, and recommendations.Key Areas of Expertise: Delegation Oversight Audits (Pre-Delegation & Annual) CMS, DHCS, DMHC, NCQA Regulatory Compliance Corrective Action Plans (CAPs) & Risk Mitigation Compliance Audit Leadership & Reporting Operational Process Improvement Regulatory Research & Interpretation Cross-Functional Collaboration with Compliance, Legal, and OperationsI’m passionate about strengthening compliance frameworks, reducing regulatory risk, and creating transparent, measurable oversight programs that help organizations deliver high-quality, compliant care. Open to connecting with compliance, auditing, and managed care professionals.
Experience
Oversight Program Auditor
Jul 2023 — Present · Los Angeles County, CA, US
Lead compliance audits for 25+ First Tier Provider Delegates, ensuring adherence to CMS, state, and federal regulations.• Develop and issue Regulatory Corrective Action Plans (CAPs) to mitigate compliance risks and improve audit outcomes.• Collaborate with Legal, Compliance, and Risk teams to strengthen oversight and regulatory adherence.• Conduct in-depth audit trend analysis, identifying and resolving compliance gaps that enhance operational efficiency.• Facilitate meetings with delegated entities to drive performance improvement and ensure regulatory compliance.
Education
Lytespeed Learning
Life Accident & Health License
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