Alliance Health este un plan regional de sănătate care deservește locuitorii din mai multe comitate din Carolina de Nord. Administrează servicii Medicaid, precum și servicii de sănătate comportamentală și servicii de specialitate finanțate de stat, inclusiv acoperirea Tailored Plan și opțiuni Medicaid Direct, care reunesc îngrijirea sănătății fizice, serviciile farmaceutice, sănătatea comportamentală, îngrijirea persoanelor cu dizabilități intelectuale și de dezvoltare și îngrijirea persoanelor cu leziuni cerebrale traumatice. Organizația coordonează serviciile prin rețele de furnizori și comitete de guvernanță și îi sprijină pe membri și furnizori prin portaluri, activități comunitare, instruire și asistență 24/7 pentru crize de sănătate comportamentală.
Internal Auditor II – Medicaid and Internal Controls
Assess governance, risk management, and internal controls across Alliance Health’s Medicaid organization. Develop standards-aligned audits, advise management, and guide audit staff.
Descriere
- Provide senior-level audit, advisory, and consulting services.
- Prepare audit programs and independently assess the soundness, adequacy, and application of functions, policies, and programs.
- Assess and strengthen governance, risk management, and internal controls.
- Lead internal audit initiatives, special projects, and improvement work under IIA Global Internal Audit Standards.
- Set audit criteria and performance measures for assigned engagements.
- Assess internal controls and operations using IIA-aligned methods.
- Assign work, guide Internal Auditor I staff, and conduct initial workpaper reviews.
- Review workpapers in detail for evidence quality, analysis, and documentation.
- Follow up on management’s corrective actions.
- Conduct internal investigations and other assigned compliance work.
- Prepare audit and advisory reports for the Director of Internal Audit to review.
- Set engagement objectives and testing strategies based on risk assessment and prioritization.
- Design audit programs and testing procedures.
- Maintain and improve internal audit methods, policies, procedures, templates, and tools.
- Keep audit work aligned with internal audit strategy, goals, and objectives.
- Help maintain the internal audit manual and contribute to staff training.
- Take part in organizational and enterprise risk management activities.
- Promote consistent use of IIA methods and standards.
- Contribute to staff development and skill-building activities.
- Mentor and coach internal audit and compliance auditors.
- Coordinate with audit staff, the Director of Internal Audit, and Alliance management.
- Build relationships with key stakeholders and provide professional audit guidance.
- Manage relationships with external auditors, regulators, and consultants.
- Record audit findings in the designated internal audit software.
- Present audit results in written reports and oral briefings.
Cerințe
- Bachelor’s degree in accounting, business administration, human services, or another relevant field from an accredited institution and at least seven years of auditing or related experience; alternatively, a master’s degree and at least five years of auditing or related experience.
- Must live in North Carolina.
- Experience reviewing contracts and/or overseeing delegated functions.
- Experience developing audit criteria where no prior framework exists.
- At least three years of managed care or government audit experience is strongly preferred.
- Knowledge of auditing and compliance standards, enterprise risk management, and audit best practices.
- Knowledge of state and federal Medicaid laws, administrative rules, state policies, and related guidance.
- General understanding of major managed care organization functions, including claims processing, utilization review, grievance management, provider credentialing, and contracting.
- Ability to interpret contracts and business documents.
- Ability to protect confidential and highly sensitive information.
- Ability to assess financial documents for accuracy, completeness, and compliance.
- Clear, concise communication with stakeholders.
- Strong analytical, decision-making, and time-management abilities.
- Ability to examine financial data and identify trends, patterns, and risks.
- Knowledge of investigative methods, including interviewing and evidence collection.
- Advanced Microsoft Office skills, including Word and Excel.
- Required certifications: Certified Internal Auditor and Certified Public Accountant.
Beneficii
- Medical, dental, vision, life, and long-term disability coverage.
- Retirement savings plan.
- Flexible schedules, including hybrid and remote options.
- Paid leave, including vacation, sick, holiday, and management leave.
- Flexible dress code.