Commonwealth Care Alliance
Sr. Associate, Internal Audit
Commonwealth Care Alliance, Boston, Massachusetts, us, 02298
Why This Role is Important to Us:
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
What You'll Be Doing: 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. 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. Contribute towards the maintenance and enhancement of an effective Compliance Monitoring Program. 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. Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program. 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.
What We're Looking For: Required Bachelor's degree from accredited institution is 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. Desired CIA, CPA, CISA, CHIAP or active progression towards the designation preferred 5+ years' work experience in auditing is preferred. 2+ years' work experience in health care preferred. Project management skills strongly preferred. Advanced technical skills (MS Excel) preferred.
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What You'll Be Doing: 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. 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. Contribute towards the maintenance and enhancement of an effective Compliance Monitoring Program. 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. Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program. 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.
What We're Looking For: Required Bachelor's degree from accredited institution is 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. Desired CIA, CPA, CISA, CHIAP or active progression towards the designation preferred 5+ years' work experience in auditing is preferred. 2+ years' work experience in health care preferred. Project management skills strongly preferred. Advanced technical skills (MS Excel) preferred.
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