Auditor
AmeriHealth Mercy Family of Companies - Philadelphia, PA

This job posting is no longer available on AmeriHealth Caritas. Find similar jobs: Auditor jobs

The Auditor position is responsible for planning and executing independent, objective internal compliance audits designed to test and confirm compliance with applicable State and Federal laws, URAC, NCQA, and SSAE-16 standards or control objectives.

The incumbent will also serve as a subject matter expert within the Company regarding standard monitoring and auditing procedures and best practices

The primary purpose of the job is to :
  • Plans and executes independent, objective internal audits designed to test and confirm compliance with applicable State and Federal laws, URAC/ NCQA UM13 accreditation standards, and internal policies and procedures.
  • Coordinates and performs audit procedures; creates work products such as audit analysis; prepares audit plan and final report summary.
  • Analyzes, understands regulatory and accreditation requirements, and applies identified requirements to business operations when developing and conducting compliance audits.
  • Selects appropriate new laws and regulations and Company policies and procedures to audit against based on risk analysis.
  • Supports the fulfillment of external audits as required.
  • Leads meetings and presents finding and recommendations to management during and at the conclusion of audits. Prepares Corrective Active Plans and monitors progress.
  • Reports audit reports and outcomes to the Compliance and Quality Committees
  • Provides training and presentations to internal departments and PerformRx customers on an as needed basis.
  • Performs other job related duties and projects as assigned.
  • Adheres to PerformRx and AmeriHealth Caritas policies and procedures.
  • Supports and carries out the Caritas Mission & Values.

Position Qualifications/Requirements:
  • Bachelor's Degree
  • One to three years experience auditing

Competencies:
  • Knowledge of standard audit practices
  • Detail oriented
  • Excellent written and verbal communication
  • Ability to analyze, develop, evaluate, write and present work product
  • Experience with presenting and or training
  • Proficiency in MS Word and Excel
  • Experience or exposure to data mining concepts

AmeriHealth Caritas - 15 months ago - save job - block
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