Medicare Auditor Jobs in Spring, TX (NOW HIRING)

Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

' Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women

' Children's Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions.

' Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs Plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high‑quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

The Senior Information Technology (IT) Internal Auditor is responsible for identifying and assessing operational, compliance, and financial risks across a variety of business functions at Community Health Choice and evaluating the design of processes and controls. The Senior Internal Auditor determines whether organizational areas are performing in accordance with internal processes, controls or established regulatory requirements.

• Independently lead and execute risk-based IT audits including SOX IT General Controls (ITGCs), operational, and compliance audits.


• Serve and contribute to the Company SOX IT compliance program through walkthroughs, documentation, and control testing.


• Manage all phases of the audit lifecycle: planning, risk assessment, fieldwork, issue identification, and reporting.


• Evaluate the design and operating effectiveness of IT controls across infrastructure, information security, cloud environments, SDLC, change management, access controls, and IT operations.


• Assess SOC 1/SOC 2 reports and other third‑party assurance reports for control reliance.


• Identify control deficiencies, assess root causes and develop practical, risk-based remediation recommendations in collaboration with management.


• Prepare clear, well‑organized audit documentation, including narratives, flowcharts, risk and control matrices, and workpapers, in accordance with IIA standards.


• Track audit findings and recommendation status; perform follow‑up testing as needed.


• Apply data analytics and technology‑enabled audit techniques to improve audit efficiency and coverage.


• Draft clear and professional audit reports, presenting findings to management and key stakeholders.


• Clearly communicate audit risks, control deficiencies, and recommendations suitable for both technical and non‑technical audiences.


• Provide timely updates on audit progress, issues, and emerging risks to audit stakeholders and Internal Audit leadership.


• Build effective working relationships and trust with business partners across the organization.


• Manage multiple audits and priorities simultaneously while meeting established timelines.


• Demonstrate flexibility and ability to adapt to a variety of roles and projects and changing demands.


• Perform other job‑related duties as assigned in support of Internal Audit objectives.

• Education/Specialized Training/Licensure: Bachelor's degree in Computer Science, Information Technology, Accounting or related fields (i.e., Finance, Business) required.


• CIA, CISA, relevant certifications or progressing toward professional certification (to be completed within 1 year of hire) required.


• MBA or relevant Master's degrees preferred.


• Work Experience: 5‑7 years of experience in IT audit, internal audit, risk/internal controls and/or compliance.


• Prior experience in public accounting Big $ or a large corporate internal audit department.


• Strong working knowledge of SOX, ITGCs, and SOC 1/SOC 2 reporting.


• Experience auditing enterprise applications and systems (e.g., ERP, HR, financial systems). Healthcare industry experience a plus.


• Management/Leadership experience leading audit engagements with minimum supervision and coordinating audit activities, as required.


• Audit & analytical competencies: demonstrate strong analytical skills in assessing complex business processes, identifying risks, and evaluating controls.


• Software proficiencies: advanced proficiency in Microsoft Office, including Excel data analysis and reporting.


• Familiarity with PeopleSoft, Visio, ACL, data analytic tools preferred.


• Experience with AI-enabled audit tools a plus.


• Proficiency in electronic audit work paper software such as Audit Board, Teammate, or similar platforms desirable.


• Other: proficient in auditing standards (e.g., IIA) and controls within business processes.


• Committed to ongoing professional development through membership in relevant organizations (IIA, AHIA).