Sr Internal Auditor

The Sr. Internal Auditor performs highly complex auditing work and is responsible for interviewing, examining, investigating and reviewing records, reports, financial statements, and management practice to ensure compliance with state statues and internal policies; and conducting audits for program economy, efficiency, and effectiveness. This role maintains organizational independence and reports functionally through the Manager, Compliance and Privacy and flows through the Executive Director of Compliance and Internal Audit, with a scope that includes, but is not limited to, healthcare regulatory and revenue-cycle compliance risk (e.g., billing/coding accuracy, HIPAA, and fraud, waste, and abuse laws).

Essential Job Functions & Accountabilities: Leads complex to highly complex and/or large-scale audits; coordinates audit assignments and activities; reviews the work of audit staff; and provides coaching and developmental feedback to support audit quality and professional growth. Develops and oversees audit plans, scopes, objectives, programs, procedures, control questionnaires, and related deliverables necessary to execute effective audit engagements.

Evaluates compliance with applicable laws, regulations, reporting requirements, and healthcare-specific regulatory standards, including billing and coding requirements, HIPAA privacy and security rules, and fraud, waste, and abuse regulations. Performs risk assessments and analyzes audit data to evaluate control effectiveness, identify control deficiencies, noncompliance, operational inefficiencies, and related risks, and develops recommendations for corrective action.

Provides quality assurance reviews of audits for completeness, compliance, uniformity in method and adherence to the Institute of Internal Auditors (IIA) Global Internal Audit standards. Applies data analytics, audit management software, and AI-assisted tools to identify trends, anomalies, and control gaps across large data sets. Works with outside auditors to help reconcile discrepancies or support the external auditing function.

Coordinates audit activities with Healthcare Information Technology and other departments to obtain necessary programming, computer time, reports and other resources needed to perform other audits. Partners with Information Technology and Information Security to assess IT general controls, cybersecurity safeguards, and disaster recovery and business continuity capabilities. Prepares draft of audit reports that presents findings and recommendations regarding area reviewed and submits to Director of Internal Audit for review.

Participates with Director in discussing findings and recommendations with responsible management of area reviewed. Provides budget and other information for specialized auditing requirements. Develops statistical and judgmental sampling and data mining techniques.

Assists in the design and administration of audit policy and procedures within the organization.

is not an all-inclusive list of duties and may be subject to change with or without notice. Staff are expected to perform other duties as assigned.