Internal Auditor - Health Care Services and Products!
Company: Fallon Health
Posted on: November 15, 2019
OverviewAbout Fallon HealthFounded in 1977, Fallon Health is a
leading health care services organization that supports the diverse
and changing needs of those we serve. In addition to offering
innovative health insurance solutions and a variety of Medicaid and
Medicare products, we excel in creating unique health care programs
and services that provide coordinated, integrated care for seniors
and individuals with complex health needs. Fallon has consistently
ranked among the nations top health plans, and is accredited by the
National Committee for Quality Assurance for its HMO, Medicare
Advantage and Medicaid products. For more information, visit
fallonhealth.org.Brief Summary of Purpose :The Internal Audit
Department (IA) at Fallon Health is committed to protecting Fallon
Health by conducting independent and objective internal audits and
assessments of its operational, financial and compliance controls.
IA reports administratively to the Chief Compliance Officer and
functionally to the Audit & Compliance Committee, and plays a key
role in auditing risks identified in the organization. The Internal
Auditor plays a key role in implementing the annual audit plan. The
Internal Auditor conducts audits and related projects (financial,
operational and regulatory in nature), documents and conveys
results and makes recommendations. This position requires a
professional with analytical and technical skills, and strong
communication skills. A desire to work in a collaborative
environment and ability to interact with all levels within the
- Assist management on audits, projects, as well as special
requests. This could include the completion of claims, operational,
financial and compliance audits, as well as, testing of internal
controls (Model Audit Rule).
- Perform all aspects of audits following departmental standards
and procedures, including walkthrough of processes, setting
objectives, defining scope, designing tests and performing the
- Analyze audit evidence to provide management with an evaluation
of the adequacy of financial, operational and regulatory controls
and make recommendations for improvement. This could include claims
testing for payment accuracy and financial accuracy.
- Communicate effectively with all levels of management to ensure
full understanding of objectives, risks, controls, and
- Ability to work in a fast-pace environment and can readily
adapt to changes within the organization or department.
- Prepare clear and concise audit reports, corrective action
plans, and other communications.
- Complete ad hoc projects as requested by management. This may
include researching potential fraud, waste or abuse related
- The primary focus of this role will be to assist management on
audits, projects, as well as special requests; independently
perform all aspects of audits following departmental standards and
- Assisting other auditors with internal audit testing.
- Identify control weaknesses within the processes, communicate
findings to process owners, and make recommendations for
- Support the Audit Department in implementing the annual audit
plan.QualificationsEducation:Bachelors degree is higly preffered,
preferably in Business Administration with a concentration in
Finance/Accounting or equivalent work experience;Masters degree a
plusLicense/Certifications :Certificate of Professional Coding
(CPC), preferred.Other Professional certification (CIA), a
- 1 to 3 years of relevant work experience can be experience
working in corporate environment, preferably in health care
environment and/or internal audit experience. Experience working in
a government program (Medicare and Medicaid), a plus.
- Proven ability to effectively communicate with all levels
within an organization.
- Possesses a high degree of integrity and confidentiality based
on exposure to personal and confidential information.
- Strong analytical ability and organizational skills
- High level understanding of internal controlsJob ID 5793#
Positions 1Category Internal Audit
Keywords: Fallon Health, Medford , Internal Auditor - Health Care Services and Products!, Accounting, Auditing , Worcester, Massachusetts
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