Sr FEP Financial Auditor

The hiring range for this role is:  

92,086.00 - 129,145.00

This role evaluates compliance with regulations and develops corrective action plans. Deliver training to BCBSA and Plans, handling complex issues. Act as a resource and consultant on audit activities, developing programs, policies, and procedures to prevent abuse. Leads and support projects, provides guidance on budget, costs, service charges, and incentives.

Primary Job Functions

• Evaluates the level of compliance with applicable federal regulations, contractual requirements and procedures at BCBSA and Plans. Maintain the BCBSA compliance plan as part of these activities and serves as the main point of contact for BCBSA and Plans financial and claims audits.

• Serves as subject matter expert for BCBSA financial policies and procedures BCBSA and Plans regarding the audit process; instructs audit flow facilitation; analyzes and assesses audit trends, best practices and risk; and develops an overall and effective audit program.

• Assists leaders with other assignments on an ad hoc basis.

• Develops and presents training to BCBSA and Plans as it relates to all types of audits.

Education, Experience, and Certification

Education

Required: Bachelor’s degree in accounting, business, finance or related field, or equivalent experience
Experience
Required:

Minimum of 4 years of related work experience, including progressively more complex assignments; proficiency with Microsoft Office or similar software (Excel, Word, PowerPoint, Outlook).

Preferred: Experience in health care or government contracting environment; Blues Plan experience
 

Certifications

Preferred Certification: Financial Services\Certified Public Accountant (CPA)

Preferred Certification: Healthcare / Insurance\ACMA - ACM - Certified Case Management Preferred Certification: Legal, Risk, Contracts & Governance\IIA - Certified Internal Auditor (CIA ​
Knowledge, Skills, and Experience

• Intermediate knowledge of auditing, finance and claims operations

• Demonstrate advanced negotiation, analytical, and problem solving skills, as well as strong project management, interpersonal, and organizational skills

• Ability to take complex audit issues and seek resolution

• Demonstrate ability to develop and maintain business relationships, as well as the ability to create strategies that support initiatives and translate these into action plans

• Ability to direct customers and related parties through influence rather than authority; excellent written, oral and presentation skills.

Financial Responsibilities
Revenue Management: No

Budget Management: No

People Management: No

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