Sr. Auditor- Controls & Compliance - The Health Plan

 
Position: Sr. Auditor- Controls & Compliance - The Health Plan

Job ID: 149050

Location: US-TX-Bellaire

Department: Controls & Compliance

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a - 5p Monday - Friday

About Texas Children's Hospital

The Texas Children’s Hospital system is the largest pediatric integrated care system and is an industry leader in pediatric population health.    Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children and pregnant women.  We are an Integrated Community System providing holistic care that empowers families to live healthier lives.  Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.  Currently, the Health Plan serves more than 450,000 members across three state territories (Harris, Jefferson, North East), who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. To join our community of 13,000 dedicated team members, visit www.texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at www.infinitepassion.org

Summary:

We are searching for a Senior Auditor – someone who works well in a fast-paced setting. In this position, you’ll be responsible for planning and conducting independent, objective assurance and consulting activities designed to add value and improve the operations of the organization. You will be using a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control, governance processes, and claims payment compliance to mitigate potential risks identified so that external audits result in no findings.

 

Think you’ve got what it takes?



Responsibilities :

Job Duties & Responsibilities

 

  • Engage in risk assessments and other departmental planning activities
  • Work with finance management team to identify high risk areas within the health plan and to initiate audit projects designed to evaluate what the risks and related financial impact is and implement controls designed to mitigate those risks
  • Identify risks outside the scope of assigned audits and other projects, documents the risks, and communicates risks to finance management
  • Independently plans, facilitates, and manages operational, financial, and compliance audits, investigations, and external audits conducted by governmental and other outside agencies
  • Oversee the Financial Statistical Audit conducted by the Health and Human Services Commission on an annual basis and is responsible for gathering information in response to the auditor’s requests and reconciling variances in the expected versus the actual outcomes
  • Manage all other external audits conducted by state agencies or other governmental bodies
  • Perform audit procedures, including conducting and documenting interviews, reviewing and analyzing evidence, identifying and defining issues, developing criteria, documenting client processes and procedures, and composing summary memos
  • Follow up on prior audit findings and recommendations within the scope of assigned projects and/or during the periodic follow-up process to determine the status of planned corrective actions
  • Communicate audit information such as results and conclusions in accordance with professional auditing standards and departmental policies and procedures
  • Creates collaborative positive working relationships with Finance staff, clients and other TCHP staff, and external parties


Qualifications:

Skills & Requirements

 

  • Bachelor’s degree in business related filed required
  • Certified Public Accountant by the Texas State of Public Accountancy
  • 5 years of progressive experience in an audit and/or accounting environment, including specific experience in performing audit assignments in a lead role required
  • Combination of education and experience may be considered as substitutions for the minimum experience requirements
  • Experience in auditing within the health care industry preferred


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