Virginia Premier Health Plan, Inc.

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Senior Internal Auditor

Senior Internal Auditor

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4070

Job Description

Overview

 

The successful candidate will effectively execute the Risk Assessment process and a wide variety of compliance and operational audits including on-going monitoring and auditing to determine that risks are managed and operations comply with internal policies and procedures, Federal, State, local and regulatory laws/agencies. The Senior Auditor will work closely with both internal departments and external vendors to assist in establishing an oversight framework for the Health Plan.

 

Responsibilities

  • Assist the Audit manager in the development of the annual Internal Audit Work Plan and Risk Assessment.
  • Perform internal audits (Compliance, Operational, IT audits) including vendor audits and ongoing activities to ensure compliance with Medicaid and Medicare regulatory requirements and determine timely resolution of issues identified, including remediation testing.
  • Lead audit engagements, including: Scheduling; Planning; Fieldwork; Wrap-up and reporting.
  • Ensure timely audit completion, accurate audit documentation and timely issues resolution reported to Sr. management;
  • Monitor performance metrics to ensure on-going compliance effectiveness including robust oversight of internal processes and vendors processes to assist in proactively identifying non-compliance issues.
  • Prepare audit reports to inform management of audit findings and Management Action Plans to address compliance or internal control issues.
  • Assist Audit Manager in leading external audit requests from State and/or Federal Regulatory agencies.
  • Lead cross-functional departmental meetings to make appropriate audit assignments and ensure timely receipt of audit deliverables to the Regulatory Auditors.
  • Identify areas of potential operational improvements and provide value-added recommendations for issues detected.
  • Provide coaching and mentoring to Staff Auditors on various audits.
  • Conduct non-routine audits, documenting and communicating findings and recommendations, explaining State and Federal regulatory requirements and overseeing the corrective actions plans for audits.
  • Develop an understanding of the operations, processes, and procedures in accordance to State and Federal contracts.
  • Perform analysis of data to evaluate the audit environment and determine risks, trends, and outliers.
  • Other duties/projects as assigned to include external provider auditing analysis.

Qualifications

MINIMUM EDUCATION REQUIREMENTS 

  • Bachelor’s degree in Finance, Accounting or a Healthcare related discipline. 

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Proficiency with MS Office products.
  • Excellent organizational and interpersonal skills
  • Ability to work effectively with co-workers as a team member.
  • Working knowledge of generally accepted auditing standards.
  • Proficiency with auditing techniques. 

WORK BACKGROUND EXPERIENCE 

  • Minimum 3 years of auditing experience preferably in Healthcare industry. 

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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