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Staff Auditor

Staff Auditor

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Job Description


Perform Compliance, operational and IT audits including any special projects for the Health Plan’s Medicaid and Medicare line of business.  The Staff Auditor will assist in planning and executing a wide variety of Compliance, Operational, Financial, IT audits, and special projects independently and with the audit manager, to ensure that risks are managed and to determine compliance with internal policies and procedures, federal, state, local and regulatory laws/agencies.  The Staff Auditor will work closely with all departments and all levels within the Health Plan and with outside agencies, as required.


  • Prepare specific audit programs, perform procedures and prepare and/or review work papers documenting and summarizing the audit procedures performed.
  • Assist in preparing written reports to inform management of audit findings and appropriate action plans to address Program Integrity or internal control matters.
  • Assist in internal audit engagements, including: scheduling; planning; coordinating opening, weekly update, and closing meetings; resolve conflicts; and ensure timely completion of those internal audits.
  • Identify areas of potential operational improvements and provide value-added recommendations for issues detected.
  • Conduct routine and non-routine audits, documenting and communicating findings and recommendations, explaining regulatory requirements and overseeing the corrective actions for audits.
  • Assist in risk assessments and preparation of work plans.
  • Develop an understanding of the operations, processes, and procedures.
  • Review and test compliance with policies and procedures, laws and regulations through the inspection of operations, processes, retrieval and review of documents and investigation of irregularities and errors.
  • Perform analysis of data to evaluate the audit environment and determine risks, trends, and outliers.
  • Work closely with Model Audit Rule team to collaborate and streamline the auditing process.
  • Assist in developing Program Integrity department policies and procedures.
  • Other duties/projects as assigned.





  • Bachelor’s degree in Finance, Accounting or a Healthcare related discipline.
  • Masters Degree and/or relevant certifications preferred



  • Knowledgeable in internal audit concepts, practices and procedures.
  • Knowledge of Microsoft software (Word, PowerPoint and Excel)
  • Excellent organizational and interpersonal skills.
  • Ability to work effectively with co-workers as a team member.
  • Ability to communicate effectively and professionally, both orally and in writing.
  • Working knowledge of generally accepted auditing standards.



  •  Minimum 1-2 years business experience preferably audit experience in the Healthcare environment.



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


About Us

Virginia Premier 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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