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Senior Internal Auditor

Community First Health Plans
Category | Professional Non-Nursing Job Schedule | Full Time Job Shift | Day Shift Job ID | 00070929 Post Date | May. 08, 2024 Department | Compliance & Regulatory
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POSITION SUMMARY/RESPONSIBILITIES

The Senior Internal Auditor is responsible for performing a variety of activities in support of compliance program initiatives, with a focus on internal auditing and monitoring, delegation oversight and testing the internal controls structure.  Responsible for execution of the Internal Audit Work Plan under the authority of the Executive Director, Compliance and Risk Management.  Contributes to the overall achievement of the department’s annual Work Plan through execution of the audits, inspections and other assignments detailed in the plan.  Conducts complex operational and compliance audits from inception to completion in accordance with departmental practices and procedures.  Evaluates and supports the development of effective internal controls designed to promote adherence with applicable federal, state laws and requirements.  Strives to protect the department’s reputation for creditability and objectivity. Collaborates with all leaders and departments throughout the course of the audit function promoting a team-oriented environment.The candidate must be familiar with current Texas Medicaid and CHIP regulations, the Texas Department of Insurance (TDI) regulations, the Office of Inspector General (OIG) Compliance Plan, and the Program Integrity requirements under the Centers for Medicare and Medicaid Services (CMS). 

EDUCATION/EXPERIENCE

           Bachelor’s degree from an accredited college or university required. A graduate degree or certifications such as CIA, CFE, CPA preferred.  Minimum of 5 years’ experience in health care compliance/internal audit, financial analysis, or contract compliance auditing.  Exceptional communication and people skills, both verbal and written. Strong understanding of automated systems and processes.  Experience with the NAIC Model Audit Rule, COSO Internal Control – Integrated Framework or managing other internal controls structures is strongly preferred. HIPAA and privacy experience preferred. 

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