Audit - Associate Auditor

Job Summary:

• Compliance and financial auditing for Delegation Oversight Experience a must.
• This position is responsible for auditing, creating reports, managing findings, and reporting results based on regulatory requirements and operational controls evaluating and monitoring activities and functions delegated to contracted, delegated entities for assigned products and business lines according to all corporate and regulatory/accreditation requirements and standards.

Required Qualifications:

• Bachelor’s degree in business or medical OR 4 or more years’ experience in a managed care environment.
• 2 to 4years’ experience in overseeing delegated oversight activities.
• Project Management skills and experience.
• Knowledge of regulatory/accreditation requirements and standards both for CMS and State requirements i.e. (TDI, HFS, NMCC, CMS, NCQA, OIG, etc.).
• Verbal and written communication skills.
• Organizational skills and the ability to handle multiple priorities.
• PC proficiency to include Word, Excel, and PowerPoint .
• Ability to Travel (20%) if applicable.

Preferred Qualifications:

• Bachelor’s degree in business, medical or public health.
• Knowledge of Power Point, Visio and Access.
• College level courses or certification in project management.
• Medical Claims Processing for both Medicaid, Medicare and DSNP a big plus.