Healthfirst is subject to various recurring and ad hoc operational, financial and/or compliance examinations from a variety of State and Federal regulatory entities. The Regulatory Audit team within the Regulatory Affairs Department is the primary liaison between Healthfirst business areas and all external regulatory auditors and examiners, overseeing and coordinating Healthfirst's responses to ensure complete and timely submissions for all lines of business.
The Regulatory Audit Manager reports to the Director, Regulatory Audit with responsibility to:
- Project manage assigned engagements of all levels of complexity, ensuring deliverables are properly assigned and all appropriate levels of management are aware of the obligations.
- Ensure deadlines are communicated and followed up on to ensure dates are met.
- Correspond with, and act as the single point of contact (SPOC) for, State & Federal examiners to ensure any questions are addressed and the requirements are understood by all stakeholders.
- Prepare business areas and all levels of personnel for upcoming external audits, including but not limited to audit basics, expectations, coordinating & facilitating education sessions, etc.
- Collaborate with Regulatory, Compliance and business areas to identify, assess and communicate audit risk ahead of upcoming examinations.
- Facilitate and provide guidance on corrective action responses to examination findings and collaborate with Compliance to ensure appropriate processes and controls are documented to address risks and deficiencies.
- Identify opportunities and collaborate with team members to implement best practices in audit and project management, including standardization of project documentation maintenance and accessibility, documentation of recurring audit processes to ensure repeatability, development of management reporting, and policy & procedure documentation.
- Contribute to Executive and Board-level reporting on audit status and potential risks.
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Minimum Qualifications:
- Prior audit project management experience, preferably with a health insurer.
- Bachelor's degree from an accredited institution with a concentration in Finance, Business Management, or a Health Management related field.
- Ability to work with all levels of management.
- Solid professional writing skills.
- Critical and analytical thinking, and problem-solving skills.
Preferred Qualifications:
- Experience or familiarity coordinating regulatory-based financial audits pertaining to New York insurance law and regulation.
- Experience in Medicare and Medicaid health insurance preferred.
- Experience working with eGRC application(s), implementation experience a plus.
- Direct experience conducting regulatory audits with such agencies as CMS, DFS, DOH, DMAHS, IPRO, OMIG and other regulatory bodies highly preferred.
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
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): $100,900 - $145,775
- All Other Locations (within approved locations): $86,500 - $128,690
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.