Chief Audit Officer

1 week ago

Wheeling, West Virginia, United States The Health Plan of West Virginia Inc Full time
Position Overview

This role is designated as a HYBRID position.

The individual in this position will act as the internal auditor for the organization, serving as a key advisor to the Board of Directors, the Audit & Corporate Compliance Committee, and the Executive Management Team. This role is essential in providing independent assurance regarding the adequacy and effectiveness of internal control systems.

The responsibilities include:

  1. Formulating, executing, and maintaining a comprehensive Annual Internal Audit Plan that evaluates internal controls aligned with the Model Audit Rule (MAR).
  2. Conducting advanced professional internal audits and offering advisory services to enhance the corporate governance framework.
  3. Collaborating with various stakeholders to develop, implement, and manage a risk-based internal controls program, which encompasses assessment, training, oversight, monitoring, and remediation of controls.
  4. Effectively communicating findings related to internal control deficiencies and risk mitigation strategies to the Board of Directors and relevant committees.
  5. Partnering with external auditors, consultants, and regulatory bodies to address identified risk areas.
  6. Coordinating with legal counsel and various departments to facilitate examinations and reviews by regulatory agencies.
  7. Leading initiatives in payment integrity, ensuring accuracy in coding, documentation, and contract application across the organization.

Reporting Structure: This position reports administratively to the Chief Financial Officer and functionally to the Chair of the Audit & Corporate Compliance Committee.

Qualifications:

  1. Bachelor's degree in accounting or finance from an accredited institution.
  2. A minimum of 10 years of professional experience in auditing, accounting, business analysis, and corporate compliance management, with at least five years in a leadership capacity.
  3. Extensive experience within the health insurance sector.
  4. Proficient in applying internal auditing and accounting principles relevant to the health insurance industry.
  5. In-depth knowledge of internal auditing standards and ethical guidelines as established by the Institute of Internal Auditors.
  6. Familiarity with management information systems terminology and practices.
  7. Comprehensive understanding of insurance industry policies, procedures, regulations, and laws.
  8. Experience in conducting quality control reviews of audit outputs.
  9. Strong planning and project management capabilities.
  10. Exceptional negotiation and problem-solving skills.
  11. Proficient in computer applications and Microsoft Office Suite.
  12. Excellent verbal and written communication skills across all organizational levels.
  13. Self-motivated with the ability to exercise independent judgment.
  14. Strong public speaking and presentation skills.

Preferred Qualifications:

  1. Experience supervising audits in Information Systems and related fields.
  2. Relevant compliance certifications.
  3. Certification as a Certified Internal Auditor (CIA) or Certified Public Accountant (CPA).

Key Responsibilities:

  1. Developing the Annual Internal Audit Plan based on a thorough risk assessment of the company's business processes for presentation to the Audit & Corporate Compliance Committee.
  2. Communicating audit results and recommendations to the Audit & Corporate Compliance Committee and management as necessary.
  3. Tracking and reporting on the implementation of audit recommendations until resolution.
  4. Ensuring the Internal Audit Department is adequately staffed, trained, and equipped to fulfill its responsibilities.
  5. Overseeing outsourced functions, ensuring consultants meet contractual obligations and that their staff is adequately trained and equipped.
  6. Staying informed on the latest developments in Internal Audit and health insurance.
  7. Directing audit staff in planning, organizing, documenting, and monitoring Internal Audit operations, including hiring, training, and evaluating personnel.
  8. Identifying and assessing the company's risk areas.
  9. Analyzing data for evidence of control deficiencies, fraud, waste, or non-compliance with regulations and policies.
  10. Overseeing the execution of internal audit procedures, including issue identification, criteria development, evidence analysis, and documentation.
  11. Communicating internal audit results and advisory project outcomes through written reports and presentations to the Board of Directors and management.
  12. Pursuing professional development opportunities, including training and membership in professional associations.
  13. Coordinating external audit activities and providing support as permitted by professional standards.
  14. Leading and supervising the Payment Integrity Department.

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