TalentBoost (Point32Health) Looking for Senior Auditor at Cranston, Rhode Island Full Time

The position reports to the Compliance Program, Audit Senior Manager and provides support for the audit activities assigned. The position also supports the Compliance Program, Audit Senior Manager in his/her leadership of the functional area of business they audit and is responsible for the efficient and timely delivery of all Compliance audit activities, as listed in the Annual Audit Plan and any related functions.

Key Responsibilities/Duties

• Performs regulatory audit activities independently under the direction of the Compliance Program, Audit Senior Manager and supports the Audit Manager across all phases of the audit (ie Scoping, Planning, Fieldwork, Reporting) to ensure audits are completed timely, with quality, and in accordance with the audit methodology.
• Supports the management of the assigned audit activities including the assessment of regulatory risks by working collaboratively with the Compliance leadership and/or their designated team members and business management to ensure processes are operating effectively, timely, and accurately.
• Uses expertise and attains knowledge of the Medicare and Medicare-Medicaid Duals regulatory industry and supports to drive a successful compliance audit program through the prevention, detection, and correction of potential issues of noncompliance and/or fraud, waste and abuse.
• Maintains productive working relationships by serving as a trusted advisor and working collaboratively with the business and management to achieve audit objectives.
• Identifies opportunities to leverage data analytics and the use of software tools to conduct audit sampling and testing.
• Conducts auditing and testing procedures that will provide for the assessment of regulatory compliance and to ensure an adequate system of internal key controls are in place to support the business processes and to ensure regulatory compliance.
• Communicates audit results with business management and facilitates the development and implementation of corrective action plans to address/correct deficiencies identified, including the tracking and reporting of said results to Leadership and Compliance Committees.

Qualifications

Education/Experience:

• Bachelor’s degree and/or advanced degree
• Certified Internal Auditor (CIA) designation, strongly preferred
• 3+ years of auditing experience within the Healthcare industry

Skills/Abilities:

• Knowledge of the Centers of Medicare and Medicaid (CMS) the Medicare Advantage program
• Knowledge of the Medicare and/or Medicaid Duals regulatory requirements
• Knowledge of auditing standards, sampling and testing methodologies, and regulatory reporting
• Knowledgeable and experienced with risk management assessments and in process improvements
• Knowledge of the general healthcare operations
• Medicare and Medicare-Medicaid Duals, Medicaid regulatory and industry knowledge
• General knowledge of the organizational departments, products and services.

Commitment to Diversity, Equity & Inclusion

Point32Health is committed to making diversity, equity, and inclusion part of everything we do-from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

COVID Policy

Please note: As of January 18, 2022, all employees – including remote employees – must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

About the Company

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

This job has been posted by TalentBoost on behalf of Point32Health. TalentBoost is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of TalentBoost not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: R4655