Full Time Remote Rn Chart Review Jobs in Raleigh, NC

The Internal Auditor II provides senior level staff advisory, consultative, and audit work to include the preparation of audit programs and independent review of various functions, policies, and programs for soundness, adequacy, and application. The Internal Auditor II ensures resources are efficiently and effectively employed and operate in compliance with the Institute of Internal Auditors Global Internal Audit Standards. The Internal Auditor II brings a systematic and disciplined approach to evaluating and improving governance, risk management, and internal controls in the achievement of Alliance’s objectives.

This position is full-time remote. The selected candidate must reside in North Carolina. Some travel for onsite meetings may be required.

Responsibilities & Duties

Auditing Execution

• Drive internal audit initiatives, special projects, and improvement initiatives in accordance with the Institute of Internal Auditors (IIA) Global Internal Audit Standards, including requirements for planning, performing, and communicating results
• Develop and apply audit criteria and performance measures for assigned engagements
• Apply IIA-aligned audit methodology when evaluating the adequacy, effectiveness, and efficiency of internal controls and ongoing operations
• Provide task assignments, guidance, and initial workpaper review for Internal Auditor I staff
• Perform detailed reviews of workpapers to ensure IIA expectations for evidence quality, analysis, and documentation are met
• Conduct periodic audit follow-ups to assess and report on progress or completion of management’s corrective actions
• Conduct other audit and compliance activities, such as internal investigations, as assigned
• Prepare audit and advisory reports for Director of Internal Audit review

Audit Methodology & Engagement Planning

• Apply the IIA’s guidance on risk assessment and prioritization when developing engagement-level audit objectives and testing strategies
• Design audit programs and testing procedures consistent with IIA guidance on planning and due professional care
• Maintain and refine internal audit methodology, including policies, procedures, templates, and tools
• Align audit activities with internal audit strategy, goals, and objectives
• Assist in defining and managing content for the internal audit manual
• Contribute to the development of the internal audit training program; work with supervisor to establish training goals

Risk Management

• Participate in organizational risk management activities, including contributing to the annual risk assessment that informs the audit plan
• Assist in the annual system-wide Enterprise Risk Management risk assessment cycle

Staff Advisor

• Support protocols to promote consistent use of IIA audit methodology
• Provide input on staff development needs and support skillbuilding activities
• Support consistent application of IIA Standards by answering questions and helping staff resolve methodological issues
• Assist with occasional knowledge sharing or focused training, as needed, to strengthen team capability
• Provide mentoring and coaching to internal auditor staff and compliance auditors (analysts)

Communication & Relationship Management

• Effectively communicate with internal audit staff, Director of Internal audit, and Alliance management
• Build relationships with key constituents and serve as a resource of professional audit advice, as appropriate
• Build and nurture key management and business relationships
• Manage external relationships, i.e. with external auditors, regulators and consultants
• Document audit results accurately and completely using the designated internal audit software
• Communicate the results of audit activities via written reports and oral presentations to appropriate management and other stakeholders

Minimum Requirements

Required:

Bachelor’s degree in accounting, business administration, human services, or other appropriate areas from an accredited college or university plus a minimum of seven (7) years’ auditing experience, or experience related to the field. 

Or

Master’s degree in accounting, business administration, human services, or other appropriate areas from an accredited college or university plus a minimum of five (5) years’ auditing experience, or experience related to the field. 

Contract review and/or delegation oversight experience is required, along with demonstrated experience developing audit criteria in situations where no prior audit framework exists.

Must possess an active professional certification as a Certified Internal Auditor (CIA); a Certified Public Accountant (CPA); or a Certification in Risk Management Assurance (CRMA)

Preferred:

At least three years of experience in managed care or government in an audit capacity is strongly preferred.

Knowledge, Skills, & Abilities

• Knowledge in auditing standards, compliance standards, enterprise risk management, and audit best practices.
• Knowledge of state and federal Medicaid laws, administrative rules, state policies, and other guidelines.
• General understanding of all major MCO functions. Particularly as they relate to claims processing, utilization reviews, grievance management, provider credentialing, and contracting.
• Ability to interpret contractual agreements and other business documents.
• Ability to maintain confidentiality and handle highly sensitive information with discretion.
• Ability to evaluate financial documents for accuracy, completeness, and compliance.
• Ability to communicate professionally and succinctly with various stakeholders.
• Excellent analytical, decision-making, and time management skills.
• Ability to analyze financial data and identify concerning trends, patterns, and other risks.
• Knowledge of investigative techniques and methods, such as interviewing, gathering evidence, etc.
• Advanced computer skills in Microsoft Office (e.g., Word, Excel).

Salary Range

$89,404 - $113,990/Annually  

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.   

 An excellent fringe benefit package accompanies the salary, which includes:     

• Medical, Dental, Vision, Life, Long and Short Term Disability
• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility