JOB SUMMARY/PURPOSE Responsible for evaluating SHPO#s adherence to key financial, operational, legal, and regulatory controls. Leads specific internal audit engagements by initiating and overseeing all fieldwork, wrap-up activities and ensuring all required activities are completed. Designs audit programs in coordination with the Compliance Department to test key controls and evaluate their effectiveness. Performs internal audit investigations throughout the health plan and compiles detailed reports with recommendations to the Compliance Officer. # This is a remote position in which we are able to employ in the following states:Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin # DEPARTMENT DESCRIPTION Provides oversight and direction for compliance with applicable federal/state rules and regulations and internal policies and procedures. This department is responsible for all lines of business in all service locations. EXPERIENCE/EDUCATION/QUALIFICATIONS Bachelor#s degree in a health, business or finance related field; or equivalent combination of related education/experience required. Master#s degree preferred. Three (3) years related business experience required. Experience must include related healthcare or regulatory duties. Experience and/or training in the following strongly preferred: Internal auditing. Financial and operational processes related to health insurance. Project planning/scoping. Government regulations specific to Centers for Medicare # Medicaid Services or the healthcare industry. KNOWLEDGE/SKILLS/ABILITIES Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities. Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions. PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 # 100% of the time) CLIMB - STAIRS LIFT (Floor to Waist: 0#-36#) 0 - 20 Lbs LIFT (Knee to chest: 24#-54#) 0 # 20 Lbs LIFT (Waist to Eye: up to 54#) 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees) STAND WALK # LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force) SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist
JOB SUMMARY/PURPOSE
Responsible for evaluating SHPO's adherence to key financial, operational, legal, and regulatory controls. Leads specific internal audit engagements by initiating and overseeing all fieldwork, wrap-up activities and ensuring all required activities are completed. Designs audit programs in coordination with the Compliance Department to test key controls and evaluate their effectiveness. Performs internal audit investigations throughout the health plan and compiles detailed reports with recommendations to the Compliance Officer.
This is a remote position in which we are able to employ in the following states:Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
DEPARTMENT DESCRIPTION
Provides oversight and direction for compliance with applicable federal/state rules and regulations and internal policies and procedures. This department is responsible for all lines of business in all service locations.
EXPERIENCE/EDUCATION/QUALIFICATIONS
Bachelor's degree in a health, business or finance related field; or equivalent combination of related education/experience required. Master's degree preferred.
Three (3) years related business experience required. Experience must include related healthcare or regulatory duties.
Experience and/or training in the following strongly preferred:
Internal auditing.
Financial and operational processes related to health insurance.
Project planning/scoping.
Government regulations specific to Centers for Medicare & Medicaid Services or the healthcare industry.
KNOWLEDGE/SKILLS/ABILITIES
Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 - 100% of the time)
CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK - LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist