Partners Health Management
External Audit Program Manager (Remote)
Partners Health Management, Elkin, North Carolina, United States, 28621
Join to apply for the
External Audit Program Manager (Remote)
role at
Partners Health Management 4 days ago Be among the first 25 applicants Join to apply for the
External Audit Program Manager (Remote)
role at
Partners Health Management Competitive Compensation & Benefits Package!
Position eligible for –
Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer
See attachment for additional details.
Office Location:
Remote Option; Available for any of Partners' NC locations
Closing Date:
Open Until Filled
Primary Purpose of Position:
The primary purpose of this position is to develop and manage the organization’s external audit program. This position will manage, oversee, and support the successful execution of external audit/review engagements in collaboration with NCDHHS, CMS, or their collaborators. This role will be responsible for developing and executing a comprehensive audit infrastructure, identifying areas for improvement, and advising the organization on risk management strategies. This role will be pivotal in driving transparency and promoting a culture of accountability.
Role And Responsibilities
External Quality Reviews
Manages the full scope of the NCDHHS External Quality Review (EQR), managing the lifecycle of the review in compliance with EQRO and NCDHHS requirements and assuring a successful review outcome for the organization. Serves as the agency contact and facilitator for NCDHHS’ External Quality Reviews and other contract-based audits. Submits findings and recommendations to the Operations Team and others as needed Manages compliance oversight reviews for external quality reviews to ensure the organization remains in a state of ever-readiness for future audits Provides project management, consultation, and support with additional external reviews as it pertains to NCDHHS contractual and/or federal requirements, as delegated (i.e.: SOC2, national accreditation, CMS...) Develops, implements, and manages a robust audit framework that adheres to best practices and regulatory requirements Leads the planning, management, and execution of audit engagements Assures external audits are completed timely, efficiently, and with a drive for positive outcomes Develops and/or manages external audit project workplans in collaboration with business owners to ensure successful audits. May additionally assist and/or manage data/information collection, quality reviews, and evaluation of audit evidence, serving as administrator for audit platforms for information exchange, and reporting to leadership on audit progress Collaborates with cross functional teams to address audit issues and facilitate effective resolutions Develops and manages department specific audit designees promoting a state of ever readiness and a culture of continuous improvement and professional development Stays abreast of industry trends, regulations, and best practices to enhance audit processes and methodologies Recommends changes and enhancements to existing policies and procedures and improve existing processes Develops, implements, and conducts improvement processes and/or implements remediation projects for ongoing compliance with state contracts and external regulators Identifies through review and analytics, the need for performance improvement projects; develops and recommends project plans, and monitors progression Reports on ongoing organizational performance with meeting compliance of external audits/reviews, contracts, or mandated requirements along with recommendations for improvements to leadership, as designated Serves on various internal and external committees, i.e., Quality Improvement Committee, Risk Management Committee/Workgroup and Regulatory Compliance Committee
Knowledge, Skills, And Abilities
Knowledge of North Carolina Tailored Plan, Medicaid Direct Plan and related managed care environment Ability to interpret and apply regulations, administrative documents and guidance, and other precedents; analyze facts, requirements, and instructions; express analysis and conclusions clearly and logically in oral and written form Demonstrated knowledge and skills in the areas of external quality review, NC DMH/I-DD/SU and DMA contracts Proven ability to lead complex audits and manage multiple projects simultaneously Ability to establish and maintain effective working relationships with leadership, staff, stakeholders, state, and federal officials Strong business acumen with the ability to align audit strategies with organizational goals Ability to exercise sound judgment, make effective decisions and resolve problems involving complex and sensitive areas Proactive approach to identifying risks and developing innovative solutions Knowledge and understanding of auditing standards and practices, as well as regulatory requirements Proficient with Microsoft Office Suite (Access, Excel, PowerPoint, and Word) Excellent interpersonal, oral, and written communication skills necessary to communicate with all levels of staff and stakeholders Proficient analytical and organizational, problem-solving, critical thinking and conflict management/resolution skills Effective attention to detail, accuracy, and precision to support research and presentation skills Ability to prioritize, plan and organize projects and tasks Ability to multi-task and meet deadlines in a fast-paced environment Ability to maintain a professional demeanor and composure when challenged Ability to function autonomously and as a team member in a multidisciplinary team Ability to train by presenting concepts and demonstrating tasks Ability to perform accurate and reliable mathematical calculations to support data analysis and measure performance Excellent project management skills
Education/Experience Required:
Master's degree in business administration, Project Management, Health Care Administration, Public Health, or related field required. Two (2) years of managed care or health plan experience required. Bachelor’s Degree and 3 years of commensurate audit management experience in lieu of specific degrees identified above is acceptable. Knowledge of Medicaid policies and data systems. Three years of experience managing projects, timelines, and deliverables is required.
Education/Experience Preferred:
Lean Six Sigma certification preferred
Licensure/Certification Requirements:
N/A Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
Job function Accounting/Auditing and Finance Industries Hospitals and Health Care Referrals increase your chances of interviewing at Partners Health Management by 2x Sign in to set job alerts for “Audit” roles.
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External Audit Program Manager (Remote)
role at
Partners Health Management 4 days ago Be among the first 25 applicants Join to apply for the
External Audit Program Manager (Remote)
role at
Partners Health Management Competitive Compensation & Benefits Package!
Position eligible for –
Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer
See attachment for additional details.
Office Location:
Remote Option; Available for any of Partners' NC locations
Closing Date:
Open Until Filled
Primary Purpose of Position:
The primary purpose of this position is to develop and manage the organization’s external audit program. This position will manage, oversee, and support the successful execution of external audit/review engagements in collaboration with NCDHHS, CMS, or their collaborators. This role will be responsible for developing and executing a comprehensive audit infrastructure, identifying areas for improvement, and advising the organization on risk management strategies. This role will be pivotal in driving transparency and promoting a culture of accountability.
Role And Responsibilities
External Quality Reviews
Manages the full scope of the NCDHHS External Quality Review (EQR), managing the lifecycle of the review in compliance with EQRO and NCDHHS requirements and assuring a successful review outcome for the organization. Serves as the agency contact and facilitator for NCDHHS’ External Quality Reviews and other contract-based audits. Submits findings and recommendations to the Operations Team and others as needed Manages compliance oversight reviews for external quality reviews to ensure the organization remains in a state of ever-readiness for future audits Provides project management, consultation, and support with additional external reviews as it pertains to NCDHHS contractual and/or federal requirements, as delegated (i.e.: SOC2, national accreditation, CMS...) Develops, implements, and manages a robust audit framework that adheres to best practices and regulatory requirements Leads the planning, management, and execution of audit engagements Assures external audits are completed timely, efficiently, and with a drive for positive outcomes Develops and/or manages external audit project workplans in collaboration with business owners to ensure successful audits. May additionally assist and/or manage data/information collection, quality reviews, and evaluation of audit evidence, serving as administrator for audit platforms for information exchange, and reporting to leadership on audit progress Collaborates with cross functional teams to address audit issues and facilitate effective resolutions Develops and manages department specific audit designees promoting a state of ever readiness and a culture of continuous improvement and professional development Stays abreast of industry trends, regulations, and best practices to enhance audit processes and methodologies Recommends changes and enhancements to existing policies and procedures and improve existing processes Develops, implements, and conducts improvement processes and/or implements remediation projects for ongoing compliance with state contracts and external regulators Identifies through review and analytics, the need for performance improvement projects; develops and recommends project plans, and monitors progression Reports on ongoing organizational performance with meeting compliance of external audits/reviews, contracts, or mandated requirements along with recommendations for improvements to leadership, as designated Serves on various internal and external committees, i.e., Quality Improvement Committee, Risk Management Committee/Workgroup and Regulatory Compliance Committee
Knowledge, Skills, And Abilities
Knowledge of North Carolina Tailored Plan, Medicaid Direct Plan and related managed care environment Ability to interpret and apply regulations, administrative documents and guidance, and other precedents; analyze facts, requirements, and instructions; express analysis and conclusions clearly and logically in oral and written form Demonstrated knowledge and skills in the areas of external quality review, NC DMH/I-DD/SU and DMA contracts Proven ability to lead complex audits and manage multiple projects simultaneously Ability to establish and maintain effective working relationships with leadership, staff, stakeholders, state, and federal officials Strong business acumen with the ability to align audit strategies with organizational goals Ability to exercise sound judgment, make effective decisions and resolve problems involving complex and sensitive areas Proactive approach to identifying risks and developing innovative solutions Knowledge and understanding of auditing standards and practices, as well as regulatory requirements Proficient with Microsoft Office Suite (Access, Excel, PowerPoint, and Word) Excellent interpersonal, oral, and written communication skills necessary to communicate with all levels of staff and stakeholders Proficient analytical and organizational, problem-solving, critical thinking and conflict management/resolution skills Effective attention to detail, accuracy, and precision to support research and presentation skills Ability to prioritize, plan and organize projects and tasks Ability to multi-task and meet deadlines in a fast-paced environment Ability to maintain a professional demeanor and composure when challenged Ability to function autonomously and as a team member in a multidisciplinary team Ability to train by presenting concepts and demonstrating tasks Ability to perform accurate and reliable mathematical calculations to support data analysis and measure performance Excellent project management skills
Education/Experience Required:
Master's degree in business administration, Project Management, Health Care Administration, Public Health, or related field required. Two (2) years of managed care or health plan experience required. Bachelor’s Degree and 3 years of commensurate audit management experience in lieu of specific degrees identified above is acceptable. Knowledge of Medicaid policies and data systems. Three years of experience managing projects, timelines, and deliverables is required.
Education/Experience Preferred:
Lean Six Sigma certification preferred
Licensure/Certification Requirements:
N/A Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
Job function Accounting/Auditing and Finance Industries Hospitals and Health Care Referrals increase your chances of interviewing at Partners Health Management by 2x Sign in to set job alerts for “Audit” roles.
We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr