Healthfirst

The work involves conducting compliance and operational audits to identify areas of risk and make recommendations to help improve operational efficiency and effectiveness; as well as, ensuring compliance with applicable laws and procedures.

Duties & Responsibilities

• Evaluate the design and effectiveness of controls to manage risk within our risk appetite and tolerance
• Audit activities of various groups for compliance with key controls compliance with plans, policies, procedures, regulatory requirements and best practices.
• Perform and control the full audit cycle including risk management and control management over operations’ effectiveness, financial reliability and compliance with all applicable directives and regulations
• Obtain, analyze and evaluate process documentation, previous reports, data, flowcharts, etc.
• Identify variances, prepare detailed explanations, and correspond with employees, management, etc. as needed to resolve discrepancies.
• Identify improvements to systems, procedures and processes to minimize risks, improve efficiency, or generate cost savings
• Apply analytical skills and knowledge of current auditing developments and standards to formulate appropriate solutions to problems
• Prepare work papers to adequately document audit work performed and to support conclusions reached
• Prepare and present reports that reflect audit’s results and document process
• Conduct follow up audits to monitor management’s interventions
• Develop an understanding of the Company’s business, risk landscape, financials, processes and control environment
• Develop knowledge regarding industry rules, regulations, best practices, tools, techniques and performance standards
• Maintain open communication with management and business leaders
• Support external auditors as assigned
• Perform special projects as needed
• Perform call monitoring of incoming and/or outgoing calls to confirm standards are met, ID performance gaps, and analyze errors to determine root causes
• Other duties as assigned.

Minimum Requirements

• Must demonstrate ability to understand and implement internal control concepts and perform root cause analysis to solve complex problems
• Ability to communicate effectively, both orally and in writing, with peers, managers, and the public, on both individual and group levels
• Advanced computer skills on MS Office (i.e., Excel, Word, PowerPoint)
• Technical and data management skills including ability to identify, obtain, format, model, manipulate, and analyze large amounts of data and compile detailed reports / dashboards
• Ability to effectively plan, organize, prioritize and complete work assignments/projects
• Must exercise accuracy, discretion, good judgment, strong attention to detail, courtesy, tact and patience
• Knowledge of accepted principles and practices of auditing, following written audit programs, and preparing adequate working papers to document audit work performed and conclusions reached
• Strong interpersonal skills; establishes and maintains good working relationships
• Must be able to properly handle sensitive or confidential company information
• Ability to work independently and meet multiple deadlines
• Strong organization skills and ability to prioritize and simultaneously handle multiple tasks or assignments
• Ability to analyze problems with detail and accuracy, keep complex records, assemble and organize data, and prepare reports from such data
• BS degree in Accounting, Finance, or Business Administration but will consider other educational background with applicable auditing or process improvement work experience
• High ethical standards and values with ability to handle confidential / sensitive issues and information with the highest degree of professional responsibility

Preferred Requirements

• Knowledge of at least two or more lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP
• Experience working in auditing, process improvement, or related field preferred
• Experience with process mapping, risk assessment, and audit tools
• Experience with data analytic software (SQL, ACL, Alteryx, Tableau)
• Familiarity with GAAP, COSO, SOX and other audit principles preferred

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $57,408 - $76,960

• All Other Locations (within approved locations): $49,795 - $72,800

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.