Chief Internal Auditor

This is a HYBRID position.

The individual in this role 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 position provides independent assurance regarding the adequacy and effectiveness of internal control processes.

The responsibilities include:

1. Formulating, executing, and maintaining an annual Internal Audit Plan that evaluates internal controls in alignment with regulatory requirements.
2. Conducting advanced professional internal audits and offering advisory services to enhance corporate governance.
3. Developing and implementing a risk-based internal controls program, which encompasses assessment, training, oversight, monitoring, and remediation of controls.
4. Effectively communicating internal control challenges and risk mitigation strategies to the Board and relevant committees.
5. Collaborating with external auditors, consultants, and regulatory agencies to address risk areas.
6. Coordinating with legal counsel and various departments to facilitate examinations by regulatory bodies.
7. Leading initiatives in payment integrity, ensuring accuracy in coding, documentation, and contract application.

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 comprehensive 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. Proficiency in applying internal auditing and accounting principles relevant to the health insurance industry.
5. In-depth knowledge of internal auditing standards and ethical guidelines.
6. Familiarity with management information systems terminology and practices.
7. Understanding of insurance industry policies, procedures, regulations, and laws.
8. Experience in conducting quality control reviews of audit deliverables.
9. Skills in planning and project management.
10. Strong negotiation and problem-solving abilities.
11. Proficient computer skills, particularly in Microsoft Office.
12. Excellent verbal and written communication skills across all organizational levels.
13. Self-motivated with the ability to exercise independent judgment.
14. Public speaking and presentation skills.

Preferred Qualifications:

1. Experience in supervising audits in Information Systems and related fields.
2. Relevant compliance certifications.
3. Certification as a CIA or CPA.

Key Responsibilities:

1. Developing the Annual Internal Audit Plan based on a comprehensive risk assessment of business processes.
2. Communicating audit findings and recommendations to the Audit & Corporate Compliance Committee and management.
3. Tracking and reporting on the implementation of audit recommendations until resolution.
4. Ensuring the Internal Audit Department is adequately staffed and equipped to fulfill its functions.
5. Supervising external consultants when functions are outsourced, ensuring performance aligns with contractual obligations.
6. Staying informed on the latest developments in Internal Audit and health insurance.
7. Leading audit staff in planning, organizing, and executing internal audit operations.
8. Identifying and assessing the organization's risk areas.
9. Analyzing data for evidence of control deficiencies, fraud, or non-compliance with regulations.
10. Overseeing the execution of internal audit procedures, including issue identification and evidence analysis.
11. Communicating audit results through written reports and presentations to the Board and management.
12. Pursuing professional development opportunities to enhance skills and knowledge.
13. Coordinating external audit activities and providing necessary support.
14. Directing and supervising the Payment Integrity Department.