Blue Shield of CA
Sr. Principal, Employee Fraud Detection & Audit
Blue Shield of CA, San Diego, California, United States, 92189
Your Role
The Employee Fraud Program Internal Auditor, Senior Principal, reporting to the Internal Audit Senior Director, is responsible for establishing, strategizing, implementing, and managing the organization's fraud detection and continuous monitoring program.
This role involves establishing a comprehensive and robust fraud control department focused on developing controls, a database of types of fraud, and what is considered fraud audit for BSC. Collaborating cross-functionally with management to mitigate fraud risks, and work with leaders to prioritize fraud prevention efforts and implement recommendations. Will build a multi-year fraud detection program and will work with IT, IT Internal Audit and across the organization to implement a continuous auditing program to detect fraud.
The role is highly cross-functional and will work with Vice Presidents, Senior Directors, and Directors across the enterprise. The role will provide coaching on control design, how controls can be tested, educate management on fraud scenarios and red flags, and support the implementation of a stronger control environment. The role will also collaborate with Legal, Cybersecurity, Physical Security, Compliance and Ethics, and Enterprise Risk Management.
Your Work
In this role, you will:
Establish a comprehensive Fraud Control Database spanning all business processes, with associated fraud categories and schemes
Facilitate Control Self-Assessment workshops for management across the enterprise, to educate employees about fraud controls, fraud risks, and prevention methods
Develop and implement a continuous fraud auditing program to analyze large volumes of data based on fraud schemes on a regular cadence or real-time to identify suspicious and/or abnormal behaviors
Ensure all fraud control owners are maintaining their controls, testing on a regular cadence, and remediating processes or controls, on an as-needed basis
Utilize data analysis tools to identify patterns and discrepancies indicative of fraud
Prepare detailed reports of the findings and present them to Senior Management
Create a culture of fraud awareness, continuous improvement and educate management on specific potential fraud schemes and fraud detection and monitoring controls
Work closely with Legal, Compliance and other departments to ensure effective fraud risk management
Stay updated with the latest fraud trends and methodologies to enhance detection capabilities
Your Knowledge and ExperienceBachelor's degree in Finance, Accounting, Criminal Justice, a related field or equivalent experienceMinimum 10 years of experience in Fraud Detection/Investigation, Auditing, or a related fieldCertified Fraud Examiner (CFE) credentials requiredCertified Internal Auditor (CIA) preferredCertified Information Systems Auditor (CISA) preferredPrevious experience in a corporate fraud prevention, detection, and monitoring programProficiency in data analysis tools and softwareStrong analytical and problem-solving skillsExpert knowledge of operations and all forms of fraud, with internal controls solutions to mitigate risk for BSCExcellent verbal and written communication and interpersonal skillsAbility to work independently and manage multiple projects simultaneouslyHigh level of integrity and confidentiality
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The Employee Fraud Program Internal Auditor, Senior Principal, reporting to the Internal Audit Senior Director, is responsible for establishing, strategizing, implementing, and managing the organization's fraud detection and continuous monitoring program.
This role involves establishing a comprehensive and robust fraud control department focused on developing controls, a database of types of fraud, and what is considered fraud audit for BSC. Collaborating cross-functionally with management to mitigate fraud risks, and work with leaders to prioritize fraud prevention efforts and implement recommendations. Will build a multi-year fraud detection program and will work with IT, IT Internal Audit and across the organization to implement a continuous auditing program to detect fraud.
The role is highly cross-functional and will work with Vice Presidents, Senior Directors, and Directors across the enterprise. The role will provide coaching on control design, how controls can be tested, educate management on fraud scenarios and red flags, and support the implementation of a stronger control environment. The role will also collaborate with Legal, Cybersecurity, Physical Security, Compliance and Ethics, and Enterprise Risk Management.
Your Work
In this role, you will:
Establish a comprehensive Fraud Control Database spanning all business processes, with associated fraud categories and schemes
Facilitate Control Self-Assessment workshops for management across the enterprise, to educate employees about fraud controls, fraud risks, and prevention methods
Develop and implement a continuous fraud auditing program to analyze large volumes of data based on fraud schemes on a regular cadence or real-time to identify suspicious and/or abnormal behaviors
Ensure all fraud control owners are maintaining their controls, testing on a regular cadence, and remediating processes or controls, on an as-needed basis
Utilize data analysis tools to identify patterns and discrepancies indicative of fraud
Prepare detailed reports of the findings and present them to Senior Management
Create a culture of fraud awareness, continuous improvement and educate management on specific potential fraud schemes and fraud detection and monitoring controls
Work closely with Legal, Compliance and other departments to ensure effective fraud risk management
Stay updated with the latest fraud trends and methodologies to enhance detection capabilities
Your Knowledge and ExperienceBachelor's degree in Finance, Accounting, Criminal Justice, a related field or equivalent experienceMinimum 10 years of experience in Fraud Detection/Investigation, Auditing, or a related fieldCertified Fraud Examiner (CFE) credentials requiredCertified Internal Auditor (CIA) preferredCertified Information Systems Auditor (CISA) preferredPrevious experience in a corporate fraud prevention, detection, and monitoring programProficiency in data analysis tools and softwareStrong analytical and problem-solving skillsExpert knowledge of operations and all forms of fraud, with internal controls solutions to mitigate risk for BSCExcellent verbal and written communication and interpersonal skillsAbility to work independently and manage multiple projects simultaneouslyHigh level of integrity and confidentiality
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