Description

PURPOSE:

The Vice President & General Auditor is responsible for directing internal audit and assurance services for all essential operations of CareFirst and its affiliated and subsidiary companies ("Company") for both commercial and government programs lines of business. The VP & General Auditor serves as the Company's Chief Audit Executive under the Institute of Internal Auditors Framework and oversees the identification, detection, assessment of internal controls and reports material control weaknesses, deficiencies and business risks to Company management, the President and CEO, and ultimately to the Audit and Compliance Committees of the Boards of Directors ("ACC"). The VP & General Auditor recommends Company policies and procedures necessary to alleviate and mitigate business risk and develops, implements, and directs programs and procedures for conducting all internal audit and assurance services. The VP & General Auditor also consults with business management and in coordination with the Chief Compliance Officer and Enterprise Risk Management function, as appropriate, issues risk assessments, advisory services corporate audit memorandums in addition to formal internal audit reports. The Vice-President & General Auditor reports to the ACC with administrative reporting to the Company's General Counsel.

ESSENTIAL FUNCTIONS:

• Directs the program of internal audit, assurance, and advisory services of financial, operational, compliance, and information technology throughout the Company to evaluate and improve the effectiveness and efficiency of internal controls, risk management and compliance with contractual obligations, laws and regulations. Directs the tracking of recommendations and management action plans, reporting the status to management and the ACC. Works with the Finance Department to ensure compliance with the National Association oflnsurance Commissioners (NAIC) Model Audit Rule by supporting Finance in assessing and implementing appropriate internal controls related to accounting and financial reporting.
• Directs audit and advisory services to the Medicare Advantage and Medicaid business. Responsible for facilitating or directly conducting the required regulatory examinations, mock audits and other advisory services to provide reasonable assurance that the Company is in compliance with the Center of Medicare and Medicaid Service requirements.
• Provides audit and advisory services to the Program and the Operations Center. Completes performance incentive plan (PIP) audits monthly, and performance reporting as required.
• Tracks and reports status of internal audit findings and significant (i.e. high, medium) open internal audit issues to Senior Management and the ACC. Collaborates with other risk areas to collect, track and drive risk mitigation across the Company.
• Supports and assists the creation of the Annual Enterprise Risk Management (ERM) Program and uses the results of the annual ERM assessment to form the basis of the Annual Internal Audit Plan that is approved by the ACC and carried out by Corporate Audit & Assurance Services.
• Provides staff support to the ACC. Recommends agenda items to the ACC Chairperson. Coordinates, prepares, and distributes ACC meeting materials and conducts pre-meeting discussions as needed with the appropriate members of Senior Management to ensure meeting materials - including minutes, presentations and agenda items - are clearly and consistently presented, understood, and include items necessary to support the topics presented on each meeting agenda.
• Conducts performance management, salary administration, budget management, and monthly reporting in order to provide staff with opportunities for professional development and an efficient reporting and management structure. Encourages professional and technical knowledge of staff by supporting educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.

Requirements

QUALIFICATIONS:
Education Level:

• Bachelor's Degree in Business Administration, Accounting, Finance, Jurisprudence, or equivalent.

 Licenses/Certifications Upon Hire Required:

• Certified Public Accountant (CPA) or Certified Internal Auditor (CIA)

Experience:

• CPA or CIA certification or equivalent. 10-15 years of related experience and 7 years of management experience. Requires a thorough understanding of the professional standards of the Institute of Internal Auditors and the NAIC Model Audit Rule and experience with implementing the appropriate internal controls to ensure compliance with corporate, association and external regulations.

Preferred Qualifications:

• Experience in health insurance and/or healthcare delivery and auditing under federal government contracts is strongly preferred.

Knowledge, Skills and Abilities (KSAs):

• Thorough understanding of control frameworks (COSO, COBIT, NIST), the professional standards of the Institute of Internal Auditors, and the NAIC Model Audit Rule, and will have experience in implementing the appropriate internal controls to ensure compliance with this and all regulations.
• Demonstrated attention to detail, analytical skills, a heightened ability to prioritize and delegate workloads, manage multiple priorities and have advanced managerial/leadership skills at an executive level.
• Excellent organization, collaboration, analytical, time management, and interpersonal skills.
• Thorough knowledge of advanced auditing and investigative techniques through the use of automation, sophisticated data; and the ability to successfully negotiate complex issues to all levels, both internally and externally.
• Experience leveraging technology to analyze and derive insights from large amounts of data, along with improving process efficiencies across the function.
• A strategic and consultative approach to audit leadership which seeks to effectively partner with and bring value to a wide array of business and functional leaders.