Responsibilities:

• Design and review audit work programs, testing strategies, and detailed testing procedures.
• Review audit responses and action plans developed by the auditee/management.
• Conduct periodic audit follow-up reviews to assess and report on progress or completion of management’s corrective action.
• Review allegations and makes recommendations for audits, investigations, or referrals to other departments.
• Represent internal audit’s goals, objectives, and viewpoints in collaborating with management and business constituents.
• Track audit and investigation activities in a centralized system from initial assignment to final disposition

Requirements:

• Bachelor’s degree in accounting, business administration, a mental health field, or related area from an accredited college or university and at least three (3) years of progressive compliance/regulatory auditing experience, preferably in a healthcare environment.
• Knowledge of best practice investigative and internal audit protocols, including interviewing, gathering evidence, etc.
• Knowledge of risk, fraud or health law.
• Knowledge of state and federal Medicaid laws, administrative rules, state policies, and other guidelines
• Ability to analyze and understand regulatory requirements, and apply pertinent imperatives to business functions when developing and conducting audits or investigations.
• Excellent analytical, decision-making, and time management skills.
• Intermediate computer skills in Microsoft Office (e.g. Word, Excel)
• Ability to maintain confidentiality and handle highly sensitive information with discretion
• Ability to evaluate clinical and administrative records for completeness and compliance.