Commonwealth Care Alliance
Sr. Associate, Internal Audit
Commonwealth Care Alliance, Boston, Massachusetts, us, 02298
012100 CCA-Internal Audit
Position Summary
Under direction of the Director of Internal Audit, the primary functions of this position are to:
Contribute towards the maintenance and enhancement of an effective Internal Audit Program
Contribute towards the maintenance and enhancement of an effective Compliance Monitoring Program
Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program
Project manage regulator and other external reviews as assigned
Contribute towards Department documentation and reporting
Supervision Exercised: Yes
Essential Duties & Responsibilities
Contribute towards the maintenance and enhancement of an effective Internal Audit
Program.
Maintain current knowledge of internal audit techniques, best practices, and professional standards. Conduct planned and ad hoc internal audits and follow-up validations of internal processes and vendors, as assigned. Apply auditing expertise to report on compliance with established internal control procedures by examining records, reports, operating practices, and documentation.
Completes audit work papers by documenting audit plan, risks, methodology, tests, findings, recommendations, executive summary, and validation. Maintain the audit documentation module for all audit work papers and make recommendations for enhancements to the module when identified.
Communicates audit findings by maintaining open and transparent communication with auditees, management, and stakeholders; preparing interim and final reports; presents findings to auditees, management, and stakeholders
Contribute towards developing CCA’s Annual Internal Audit Plan based on identified risks and identifying beneficial and value-added audits.
Maintain current knowledge of and identify business and compliance risks using various sources and methods.
Make recommendations towards enhancement of the Annual Compliance Audit Plan development process.
Make recommendations towards enhancement of the Internal Audit Program processes, templates, and tools.
Continually monitor progress of assigned audits, report to Director of Internal Audit and suggest modifications and adjustments.
Participate in communicating Internal Audit and Monitoring Plan schedule to CCA staff
Make recommendations for and execute training and education for CCA staff about Compliance Audit, Monitoring, and Risk Assessment Programs. Support team in similar activities for CAP Program.
Provide guidance and mentoring to Internal Auditor(s) in the scope of their daily responsibilities.
Drive business owners to develop, maintain, and enhance compliance monitoring reports
Work collaboratively with business departments to develop and enhance their monitoring Activities
Contribute to the proposal of the Annual Compliance Monitoring Plan.
Make recommendations towards enhancement of the Annual Compliance Monitoring Plan development process.
Make recommendations towards enhancement of the Compliance Monitoring Program processes and provide guidance to align the program with CCA data analytics and intelligence enhancement objectives.
Support and contribute to completion of Commonwealth Care Alliance’s (CCA) annual Compliance Risk Assessment.
Make recommendations towards enhancements to the Continuous Compliance Risk Assessment process.
Alert Director of Internal Audit of identified new or emerging compliance risks throughout the year and make recommendations towards potential impact on the Annual Internal Audit Plan or Annual Compliance Monitoring Plan.
Project manage regulator and other external reviews as assigned
Lead the coordination of external audits when noticed by regulators or when hired by CCA to conduct an external audit
Communicate project deliverables and deadlines to internal stakeholders, points of contact, and vendors
Collect and track deliverables to ensure timely and quality completion
Represent CCA in a liaison capacity by serving as point of contact for external auditor/reviewer, exhibiting the highest level of professionalism and courtesy.
Maintain current industry knowledge of highly impactful external audits such as Risk Adjustment Data Validation Audit, CMS Program Audit protocols, common findings, and best practices. Support and contribute towards CCA education on these topics.
Contribute towards Department documentation and reporting
Maintain and update documentation in coordination with colleagues of current processes and controls.
Support Internal Audit reporting through dashboard updates to team and management
Participate and contribute to development and enhancement of metrics for reporting key performance indicators
Additional Responsibilities
Support Corrective Action Plan (CAP) Manager in communicating on new and existing CAPs emerging from source programs above and recommended
Present updates and reports as requested.
Provide support to team members or manager when requested.
Other duties as assigned.
Secondary Responsibilities
Contribute towards the overall Department Regulatory Affairs and Compliance infrastructure at CCA.
Promote compliance in CCA’s business operations with all Medicare and Medicaid contractual and regulatory requirements.
Project manage multiple organization-wide initiatives that occur on an annual or on an ad hoc basis.
Working Conditions:
Standard office conditions with ability to travel to CCA sites as needed.
Must be able to travel locally to CCA/CCC offices and conferences via public transportation and/or personal vehicle, as needed
Minimal travel may be required
Required Education:
Bachelor’s degree from accredited institution is required.
Desired Licensing:
CIA, CPA, CISA, CHIAP or active progression towards the designation preferred
Desired Experience:
5+ years’ work experience in auditing is preferred.
2+ years’ work experience in health care preferred.
Knowledge, Skills & Abilities (Required)
Strong written, verbal, listening, presentation, and communication skills – having the ability to understand and communicate appropriately to the targeted audience.
Strong analytical skills – having the ability to identify an issue, conduct an analysis to determine business impact (including gap analyses), troubleshoot and identify solutions.
Strong project management skills - having the ability to effectively manage multiple priorities simultaneously by maintaining established timeframes, adhering to work plans and communicating changes effectively.
Ability to influence team members and business owners to resolve issues in a timely manner.
Diplomatic and negotiation skills and understanding of needs of internal and external partners.
Ability to work independently and with minimal supervision.
Self-directed with proven initiation skills.
Ability to present information clearly in meetings and to communicate with team members and senior leadership.
Excellent interpersonal skills in order to communicate and work with staff of all skill and experience
levels.
Attention to detail.
Strategic thinking and planning for Programs assigned to this position - ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions.
Must be able to effectively communicate with colleagues, internal customers, and vendors
Knowledge, Skills & Abilities (Desired)
Project management skills strongly preferred.
Advanced technical skills (MS Excel) preferred.
Language(s): English
Other:
Equipment Utilized:
General office equipment; computers, telephones, copy machines, scanners, faxes.
Physical Requirements:
Position requires constant operation of a computer and other office equipment (i.e., copy machine, Polycom equipment, and computer printer)
Must be able to remain in a stationary position 50 percent of the time
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Position Summary
Under direction of the Director of Internal Audit, the primary functions of this position are to:
Contribute towards the maintenance and enhancement of an effective Internal Audit Program
Contribute towards the maintenance and enhancement of an effective Compliance Monitoring Program
Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program
Project manage regulator and other external reviews as assigned
Contribute towards Department documentation and reporting
Supervision Exercised: Yes
Essential Duties & Responsibilities
Contribute towards the maintenance and enhancement of an effective Internal Audit
Program.
Maintain current knowledge of internal audit techniques, best practices, and professional standards. Conduct planned and ad hoc internal audits and follow-up validations of internal processes and vendors, as assigned. Apply auditing expertise to report on compliance with established internal control procedures by examining records, reports, operating practices, and documentation.
Completes audit work papers by documenting audit plan, risks, methodology, tests, findings, recommendations, executive summary, and validation. Maintain the audit documentation module for all audit work papers and make recommendations for enhancements to the module when identified.
Communicates audit findings by maintaining open and transparent communication with auditees, management, and stakeholders; preparing interim and final reports; presents findings to auditees, management, and stakeholders
Contribute towards developing CCA’s Annual Internal Audit Plan based on identified risks and identifying beneficial and value-added audits.
Maintain current knowledge of and identify business and compliance risks using various sources and methods.
Make recommendations towards enhancement of the Annual Compliance Audit Plan development process.
Make recommendations towards enhancement of the Internal Audit Program processes, templates, and tools.
Continually monitor progress of assigned audits, report to Director of Internal Audit and suggest modifications and adjustments.
Participate in communicating Internal Audit and Monitoring Plan schedule to CCA staff
Make recommendations for and execute training and education for CCA staff about Compliance Audit, Monitoring, and Risk Assessment Programs. Support team in similar activities for CAP Program.
Provide guidance and mentoring to Internal Auditor(s) in the scope of their daily responsibilities.
Drive business owners to develop, maintain, and enhance compliance monitoring reports
Work collaboratively with business departments to develop and enhance their monitoring Activities
Contribute to the proposal of the Annual Compliance Monitoring Plan.
Make recommendations towards enhancement of the Annual Compliance Monitoring Plan development process.
Make recommendations towards enhancement of the Compliance Monitoring Program processes and provide guidance to align the program with CCA data analytics and intelligence enhancement objectives.
Support and contribute to completion of Commonwealth Care Alliance’s (CCA) annual Compliance Risk Assessment.
Make recommendations towards enhancements to the Continuous Compliance Risk Assessment process.
Alert Director of Internal Audit of identified new or emerging compliance risks throughout the year and make recommendations towards potential impact on the Annual Internal Audit Plan or Annual Compliance Monitoring Plan.
Project manage regulator and other external reviews as assigned
Lead the coordination of external audits when noticed by regulators or when hired by CCA to conduct an external audit
Communicate project deliverables and deadlines to internal stakeholders, points of contact, and vendors
Collect and track deliverables to ensure timely and quality completion
Represent CCA in a liaison capacity by serving as point of contact for external auditor/reviewer, exhibiting the highest level of professionalism and courtesy.
Maintain current industry knowledge of highly impactful external audits such as Risk Adjustment Data Validation Audit, CMS Program Audit protocols, common findings, and best practices. Support and contribute towards CCA education on these topics.
Contribute towards Department documentation and reporting
Maintain and update documentation in coordination with colleagues of current processes and controls.
Support Internal Audit reporting through dashboard updates to team and management
Participate and contribute to development and enhancement of metrics for reporting key performance indicators
Additional Responsibilities
Support Corrective Action Plan (CAP) Manager in communicating on new and existing CAPs emerging from source programs above and recommended
Present updates and reports as requested.
Provide support to team members or manager when requested.
Other duties as assigned.
Secondary Responsibilities
Contribute towards the overall Department Regulatory Affairs and Compliance infrastructure at CCA.
Promote compliance in CCA’s business operations with all Medicare and Medicaid contractual and regulatory requirements.
Project manage multiple organization-wide initiatives that occur on an annual or on an ad hoc basis.
Working Conditions:
Standard office conditions with ability to travel to CCA sites as needed.
Must be able to travel locally to CCA/CCC offices and conferences via public transportation and/or personal vehicle, as needed
Minimal travel may be required
Required Education:
Bachelor’s degree from accredited institution is required.
Desired Licensing:
CIA, CPA, CISA, CHIAP or active progression towards the designation preferred
Desired Experience:
5+ years’ work experience in auditing is preferred.
2+ years’ work experience in health care preferred.
Knowledge, Skills & Abilities (Required)
Strong written, verbal, listening, presentation, and communication skills – having the ability to understand and communicate appropriately to the targeted audience.
Strong analytical skills – having the ability to identify an issue, conduct an analysis to determine business impact (including gap analyses), troubleshoot and identify solutions.
Strong project management skills - having the ability to effectively manage multiple priorities simultaneously by maintaining established timeframes, adhering to work plans and communicating changes effectively.
Ability to influence team members and business owners to resolve issues in a timely manner.
Diplomatic and negotiation skills and understanding of needs of internal and external partners.
Ability to work independently and with minimal supervision.
Self-directed with proven initiation skills.
Ability to present information clearly in meetings and to communicate with team members and senior leadership.
Excellent interpersonal skills in order to communicate and work with staff of all skill and experience
levels.
Attention to detail.
Strategic thinking and planning for Programs assigned to this position - ability to initiate and develop new solutions to problems, to identify new opportunities; and have organizational perspective to see how the pieces fit and reflect that perspective in day-to-day decisions.
Must be able to effectively communicate with colleagues, internal customers, and vendors
Knowledge, Skills & Abilities (Desired)
Project management skills strongly preferred.
Advanced technical skills (MS Excel) preferred.
Language(s): English
Other:
Equipment Utilized:
General office equipment; computers, telephones, copy machines, scanners, faxes.
Physical Requirements:
Position requires constant operation of a computer and other office equipment (i.e., copy machine, Polycom equipment, and computer printer)
Must be able to remain in a stationary position 50 percent of the time
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.