General Statement of Duties

The Senior Internal Auditor conducts audits to assess the effectiveness of internal controls, the accuracy of financial records, and the efficiency of operations and business systems.  This position also ensures that appropriate policies and procedures are in place and followed consistently throughout the organization in order to safeguard its assets, verify the accuracy and reliability of its data, and promote adherence to prescribed policies and procedures.  The Senior Internal Auditor develops and leads audits with little or no supervision, as well as serves as a resource for other audit staff.

Essential Position Functions

• Analyzes data to determine whether there is any evidence of internal control deficiencies, duplication of efforts, or Fraud, Waste, and Abuse
• Examines department records and interviews personnel to evaluate the accurate recording of transactions
• Evaluates the administrative, internal and accounting controls
• Evaluates the adequacy of policies and procedures in place to provide reasonable assurance that the organization’s assets are properly safeguarded and recorded in the financial records
• Performs attribute and transaction testing
• Reviews pertinent documents necessary to determine if an audit trail exists for all records
• Discusses findings with and determines the factual accuracy of the findings with the supervisor or Director of the area/department audited
• Evaluates compliance with laws, government regulations, and management policies and procedures applicable to the organizations operations in all lines of business
• Assists external auditors and compliance officers from CMS, OMAP, Insurance Commissioner, or other regulatory public agencies in site audits of delegated entities
• Prepares work papers, documentary evidence and reports of all audit work in accordance with professional auditing standards
• Prepares recommendations for improvements or corrective actions for each area where it is determined that a deficiency may exist

• Drafts reports of findings and recommendations which have been reviewed and approved by the Audit and Compliance Manager and/or Officer to the Controller, COO/CFO, Board of Directors or Committees thereof and as approved by the COO/CFO, Board of Directors or Committees thereof to governing bodies on the compliance of the Company with administrative, internal and accounting controls, laws and regulations
• Conducts special studies for the executive management team, Board of Directors or Committee thereof under the supervision of the Audit and Compliance Officer
• Monitors activity and file maintenance in accounting records and data processing systems. Assist the Audit and Compliance Manager in monitoring User Access controls to the QNXT claims system
• Serves as a technical resource to other audit staff

Essential Department and Organizational Functions

• Propose and implement process improvements
• Meet deadlines for completion of workload
• Maintain agreed upon work schedule
• Demonstrate cooperation and teamwork
• Provide cross-training on specific job responsibilities
• Meet identified business goals that contribute to departmental goals
• Perform other duties and projects as assigned

Knowledge, Skills and Abilities Required

• Thorough knowledge of accounting and auditing practices/procedures
• Advanced understanding of Sarbanes Oxley regulations
• An understanding of, and adherence to, the Auditors Code of Ethics and the Standards for the Professional Practice of Internal Auditing as developed by the Institute of  Internal Auditors
• Advanced knowledge of  managed health plan operations
• Strong analytical skills
• Proven investigative and reporting skills
• Strong verbal and written communication skills, as well as interpersonal and presentation skills
• Excellent computer skills, including MS Office Word and Excel

Education and/or Experience

Minimum 5 years’ experience in auditing required, including experience in managed care. Bachelor's degree in Business, Accounting, or related field preferred.  Designation as a CPA or CIA also preferred. 

Working Conditions

• Environment:  This position’s primary responsibilities typically take place in the following environment(s) (check all that apply on a regular basis):

? Inside/office            ? Clinics/health facilities         ? Member homes

? Other_________________________________________

• Travel:  This position may include occasional required or optional travel outside of the workplace, in which the employee’s personal vehicle, local transit, or other means of transportation may be used.
• Equipment:  General office equipment
• Hazards:  n/a

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment

Veterans are strongly encouraged to apply. 

Equal opportunity employer.  This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.