Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
JOB SUMMARY
The Senior Internal Auditor is responsible for leading audits underlying CHC's internal audit and controls program. The Senior Internal Auditor executes audits in financial, operational, and compliance areas to safeguard company resources and ensure the effectiveness and efficiency of operations.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Lead and conduct internal audits and MAR controls assessments, including prepare workpapers and review the workpapers of other auditors to ensure quality and objectives of audits are achieved.
Develop comprehensive audit programs, including understanding of current business risks and controls, to identify areas of risk that may require stronger controls and to prioritize audit steps and test plans.
Perform and document testing and walkthroughs of processes and controls, with appropriate validation.
Prepare well written and concise audit reports on results of audit for review by Internal Audit Manager or above.
Make practical recommendations for process improvements while ensuring that recommendations reflect an understanding of the business and are clearly presented to and agreed to by management.
Communicates results of audit projects to management and operations personnel directly involved with department projects.
Conduct audit follow-up activities.
Develop and maintain effective working relationships with multiple management levels within the CHC while able to work objectively and independently.
Demonstrate attention to detail, strong organizational skills, tolerance for uncertainty, and ability to be agile and adaptable.
Strong analytical skills and ability to consider and develop sound solutions beyond generic recommendations.
Other duties as assigned.
QUALIFICATIONS:
Education/Specialized Training/Licensure: Bachelor's degree in accounting or related fields (i.e., Finance, Business) required.
CIA, CPA, or relevant certification preferred.
Work Experience (Years and Area):
Three (3) to five (5) years of internal audit experience with a focus on compliance (SOX), financial, or operational auditing
Public Accounting/Big 4 and/or Healthcare industry experience a plus.
Software Proficiencies: Proficient in Microsoft Office software programs Familiarity with PeopleSoft, Visio, ACL, data analytic tools preferred.
Experience using Electronic Audit Work Paper Software such as Audit Board, Teammate, etc. a plus.
Other: Working knowledge of auditing techniques and standards (i.e., International Standards for the Professional Practice of Internal Auditing)
Understanding of the risk and controls associated with business processes and ability to identify those risk and controls.
Continuing education required, such as participation in professional audit organizations (IIA, AHIA, HCCA, etc.)
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