The Internal Auditor functions with considerable independence and performs general audit activities to ensure adequate managerial and accounting controls exist and function properly; established laws, rules and regulations are being followed; established policies, practices and procedures are effectively and efficiently executed; and ensures that assets and resources are efficiently utilized and adequately safeguarded. The Internal Auditor will provide executive staff with assessments and advice for improving internal processes that will advance the goals and objectives of MCHCP.
Department: Internal Audit
Supervision Received: Work is performed under the general supervision of the Chief Financial Officer.
Supervision Exercised: None.
FLSA Status: Exempt. The position qualifies for the executive exemption under the Fair Labor Standards Act.
Essential Job Functions and Responsibilities: (This list is neither all-inclusive, nor restrictive; management reserves the right to further define duties based on operational needs.)
Prepares a comprehensive annual audit plan aligning the plan with organizational goals and objectives while assessing internal risks and incorporating the flexibility for review of emerging risk relevance. The audit plan shall assess major risk areas on at least an annual basis and determine priorities of audit activities in conjunction with executive management.
Conducts periodic evaluation of internal controls, especially as they relate to member enrollment and eligibility issues, and assists management in the assessment of internal controls.
Evaluates and oversees external audits to ensure vendor compliance with audit objectives, project timelines and reporting deliverables.
Performs audits of MCHCP activities as deemed relevant in relation to the Plan’s risk assessment.
Reviews and monitors the administrative controls in the various sections of MCHCP.
Prepares detailed audit reports and recommendations for correcting concerns and improving processes.
Provides ongoing educational sessions to staff on what internal controls are and why they are important to MCHCP.
Evaluates risk of fraud, waste and abuse and the manner in which prevention, deterrence, and detection of fraud, waste and abuse is managed by MCHCP.
Performs other related duties as needed or assigned.
Required Knowledge, Skills, and Abilities:
Extensive knowledge of accounting and auditing standards and techniques. (The incumbent is expected to follow the International Standards for the Professional Practice of Internal Auditing as promulgated by the Institute of Internal Auditors (IIA)).
Sufficient knowledge to evaluate the risk of fraud, waste, and abuse and the manner it is managed by the organization, knowledgeable of proper investigation techniques related to potential fraud, waste and abuse in compliance with generally accepted auditing standards.
Extensive knowledge of Microsoft Access, Excel, and Word; prefer knowledge of Audit Command Language (ACL).
In-depth knowledge of general health care delivery systems, operations and administration desired.
Familiar with COGNOS based user interface in order to extract, interpret, and analyze health care cost and utilization.
Must comply with ethical standards as described with IIA and must demonstrate the highest integrity and ethical behavior in daily work activities.
Sufficient knowledge of key information technology risks, controls and available technology-based audit techniques including those pervasive to cloud strategies, governance, security and privacy.
Considerable knowledge of the general principles of management and supervision and of office management procedures.
Ability to prepare audit reports and programs and present in oral and written formats as needed. Must maintain audit work papers and documentation consistent with MCHCP record retention policies and procedures.
Ability to read and understand tax laws, financial industry rules and regulations, federal and state laws, and determine their applicability to MCHCP processes.
Ability to perform detailed work using statistical and financial data, ability to interpret complex financial and statistical statements, and generate comprehensive reports from same.
Must possess strong organizational and time management skills and be detail oriented.
Excellent communication and analytical skills.
Ability to prepare, review, and administer the Internal Audit Department budget.
Ability to establish and prioritize goals, and evaluate performance.
Ability to serve as a productive team member and the ability to demonstrate a professional and positive attitude while establishing and maintaining excellent working relationships with MCHCP management and staff; MCHCP members; health plan representatives; Audit Committee members; the Board of Trustees; and general public.
Ability to maintain confidentiality of all MCHCP information and records in accordance with Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws and regulations.
Ability to quickly adapt to changes in the highly dynamic field of health care.
Ability to make independent decisions in accordance with established policies and procedures; and ability to prioritize, organize and perform work independently and under pressure.
Ability to project a professional image through oral and written communication and appearance.
Bachelor degree from an accredited four-year college or university with specialization in a business related field, preferably accounting or auditing
At least five years of related professional work experience, with at least two years as a lead or chief internal auditor or at least two years performing independent audits.
Certified Public Accountant (CPA) or Certified Internal Auditor (CIA); prefer dual certifications. Master of Business Administration degree from an accredited college or university may be substituted for certifications.