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Healthfirst Senior QA Auditor in New York, New York

The Sr QA Auditor is responsible for conducting operational audits to objectively support HF Management’s ability to identify and mitigate key financial and operational risks and make recommendations and collaborate with business leaders on implementation of CAP/MAP (Corrective/Management Action Plan(s) to help improve operational efficiency and effectiveness; as well as, ensuring compliance with applicable laws and procedures.

Duties & Responsibilities:

  • Evaluate the design and effectiveness of processes and controls to manage risk in accordance with Enterprise requirements and risk tolerance/thresholds.

  • Assist more junior auditors through training, coaching, and functioning as first-level of support.

  • Audit activities of various operational processes for compliance with key control plans, policies, procedures, regulatory requirements, SLAs, and industry best practices.

  • Design and execute the full audit lifecycle including risk management and control management over operational effectiveness, financial reliability, and compliance with all applicable directives and regulatory requirements.

  • Obtain, analyze, and engage with operational leaders and their teams on opportunities for improvement of process documentation, workflow diagrams, trends analysis, operational controls, exception handling, quality metrics, etc.

  • Identify variances, prepare detailed explanations, and correspond with employees, management, and other stakeholders to implement action plans and resolve discrepancies.

  • Identify improvements to systems, procedures, and processes to minimize risks, improve efficiency, or generate cost savings.

  • Apply analytical skills and knowledge of current auditing developments and standards to formulate appropriate solutions to problems.

  • Prepare reports to adequately document audit or test results and to support conclusions and recommendations.

  • Monitor the progress of remediation activities by maintaining and reviewing list of process and control failures and retest as necessary.

  • Develop an understanding of the supported operational businesses, risk landscape, financials, processes, and control environment.

  • Develop knowledge regarding industry rules, regulations, best practices, tools, techniques, and performance standards.

  • Support internal and external auditors as needed or assigned.

  • Perform special projects.

  • Other duties as assigned.

Minimum Requirements:

  • Work experience with internal control concepts and root cause analysis to solve complex problems.

  • Experience utilizing accepted principles and practices of auditing, following written audit programs, and preparing adequate working papers to document audit work performed and conclusions reached.

  • Work experience requiring written and verbal communication that is clear, concise, grammatically correct, and professional.

  • Advanced computer skills on MS Office (i.e., Excel, Word, PowerPoint)

  • Technical and data management skills including ability to identify, obtain, format, model, manipulate, and analyze large amounts of data and compile detailed reports / dashboards

  • Strong interpersonal skills; establishes and maintains good working relationships

  • BS degree in Accounting, Finance, or Business Administration or equivalent and/or relevant work experience.

Preferred Requirements:

  • Knowledge of at least two or more lines of business such as Medicare NY, Medicaid, Child Health Plus, QHP, EP, HARP.

  • Experience with process mapping, risk assessment, or related audit tools.

  • Experience with data analytic software (SQL, ACL, Alteryx, Tableau).

  • Familiarity with GAAP, COSO, SOX and other audit principles preferred.

Compliance & Regulatory Responsibilities: See Above

License/Certification: N/A

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $81,100 - $117,470

  • All Other Locations (within approved locations): $71,600 - $106,505

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

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