Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness,andencounter data integrity. * Partner with compliance, legal ...
Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness,andencounter data integrity. * Partner with compliance, legal ...
VP, Internal Audit
Orange, CA · On-site
Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness, and encounter data integrity. * Partner with compliance, legal ...
VP, Internal Audit
Orange, CA · On-site
Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness, and encounter data integrity. * Partner with compliance, legal ...
Audit Manager - Insurance and Banking
Manhattan Beach, CA · On-site
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
Manhattan Beach, CA · On-site
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
Los Angeles, CA · On-site
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
Los Angeles, CA · On-site
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Audit Manager - Insurance and Banking
$120K - $160K/yr
GAAP and Statutory Accounting Principles (SAP) as they apply to property & casualty and/or life insurance companies, including familiarity with statutory financial reporting, the Model Audit Rule ...
Senior Technical Governance Manager
$94.19 - $103.45/hr
AI Audit Methodologies: Develop, operationalize, and execute rigorous audit processes for AI models that address Privacy, InfoSec, Legal and other risks. * AI Risk Register Management: Build and ...
Quick apply
Senior Technical Governance Manager
$94.19 - $103.45/hr
AI Audit Methodologies: Develop, operationalize, and execute rigorous audit processes for AI models that address Privacy, InfoSec, Legal and other risks. * AI Risk Register Management: Build and ...
Tigergraph DB Developer
Sunnyvale, CA · On-site
Create and handle users, roles, and privileges using TigerGraph's RBAC model; * Audit query activity and ensure compliance with data governance policies; * Monitor query performance, memory usage ...
Quick apply
Tigergraph DB Developer
Sunnyvale, CA · On-site
Create and handle users, roles, and privileges using TigerGraph's RBAC model; * Audit query activity and ensure compliance with data governance policies; * Monitor query performance, memory usage ...
AVP, Internal Audit
San Diego, CA · On-site
$85K - $140K/yr
This role is a key driver of technology-forward audit innovation, helping Axos Bank harness AI, data modeling, and advanced analytics to elevate audit quality and efficiency. This role partners ...
AVP, Internal Audit
San Diego, CA · On-site
$85K - $140K/yr
This role is a key driver of technology-forward audit innovation, helping Axos Bank harness AI, data modeling, and advanced analytics to elevate audit quality and efficiency. This role partners ...
AVP, Internal Audit
$85K - $140K/yr
This role is a key driver of technology-forward audit innovation, helping Axos Bank harness AI, data modeling, and advanced analytics to elevate audit quality and efficiency. This role partners ...
AVP, Internal Audit
$85K - $140K/yr
This role is a key driver of technology-forward audit innovation, helping Axos Bank harness AI, data modeling, and advanced analytics to elevate audit quality and efficiency. This role partners ...
Our client service model focuses on quick response times and efficient audit services. As a CPA firm, we provide audit services to small to mid-cap companies and our structure allows for more ...
Our client service model focuses on quick response times and efficient audit services. As a CPA firm, we provide audit services to small to mid-cap companies and our structure allows for more ...
Audit Supervisor
$75K - $130K/yr
The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...
Audit Supervisor
$75K - $130K/yr
The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...
Audit Supervisor
Costa Mesa, CA · On-site
$75K - $130K/yr
The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...
Audit Supervisor
Costa Mesa, CA · On-site
$75K - $130K/yr
The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...
Audit, Risk & Compliance Lead the enterprise AI assurance and audit program by setting the ... Fosters a culture aligned to BMO purpose, values and strategy and role models BMO values and ...
Audit, Risk & Compliance Lead the enterprise AI assurance and audit program by setting the ... Fosters a culture aligned to BMO purpose, values and strategy and role models BMO values and ...
Audit Supervisor
Costa Mesa, CA · On-site
$75K - $130K/yr
The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...
Quick apply
Audit Supervisor
Costa Mesa, CA · On-site
$75K - $130K/yr
The Audit Supervisor is a key part of our team - you will plan/perform increasingly complex work in ... We fully understand that every employee has different needs, so our unique business model allows ...
Audit Director
Irvine, CA · On-site
Audit Director Summary: Our client is a full service public accounting firm that has embraced ... Understand the firm's financial model and ensure profitable delivery of engagements. * Expand ...
Audit Director
Irvine, CA · On-site
Audit Director Summary: Our client is a full service public accounting firm that has embraced ... Understand the firm's financial model and ensure profitable delivery of engagements. * Expand ...
Audit Manager
Redwood City, CA · On-site
$120K - $157K/yr
Audit Manager Advance your career with us and be a part of a five-decade legacy of working with the ... Act as a role model and mentor to new and existing staff by creating a positive work environment ...
Audit Manager
Redwood City, CA · On-site
$120K - $157K/yr
Audit Manager Advance your career with us and be a part of a five-decade legacy of working with the ... Act as a role model and mentor to new and existing staff by creating a positive work environment ...
Develop, train, and implement proprietary machine learning and AI models, to scale up audit testing insights. - Professional Development: Continue to develop and expand knowledge in data analytics ...
Develop, train, and implement proprietary machine learning and AI models, to scale up audit testing insights. - Professional Development: Continue to develop and expand knowledge in data analytics ...
Develop, train, and implement proprietary machine learning and AI models, to scale up audit testing insights. - Professional Development: Continue to develop and expand knowledge in data analytics ...
Develop, train, and implement proprietary machine learning and AI models, to scale up audit testing insights. - Professional Development: Continue to develop and expand knowledge in data analytics ...
Model Audit information
What are some common challenges faced by professionals in Model Audit roles, and how can they effectively address them?
What are model audit jobs?
What is the difference between Model Audit vs Data Analyst?
| Aspect | Model Audit | Data Analyst |
|---|---|---|
| Required Credentials | Certifications in auditing, data science, or analytics | Degree in statistics, data science, or related field |
| Work Environment | Financial institutions, tech companies, consulting firms | Business, finance, healthcare, marketing sectors |
| Employer & Industry Usage | Used to ensure model compliance and accuracy | Used to interpret data and generate reports |
Model Audits focus on evaluating the accuracy, compliance, and robustness of predictive models, often within financial or tech industries. Data Analysts interpret and visualize data to support decision-making. While both roles require analytical skills and familiarity with data tools, Model Auditors emphasize validation and regulatory compliance, whereas Data Analysts focus on data interpretation and reporting.
What are the key skills and qualifications needed to thrive as a Model Auditor, and why are they important?
Alignment Healthcare rating
7.3
Based on 17 frontline employees who took The Breakroom Quiz
232nd of 298 rated insurance
Job description
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
The VP, Internal Audit is a highly visible senior leadership role responsible for directing the internal audit function at Alignment Healthcare, Inc., with accountability for SOX compliance, enterprise risk management, and regulatory oversight across all business operations. This leader works in close partnership with the Audit Committee, CFO, CAO, executive leadership, legal, compliance, finance, and business unit leaders to strengthen the overall control environment and position internal audit as a trusted advisor-not merely a compliance function. Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces emerging risks, and ensures the organization operates with the highest standards of accountability. This is a critical enterprise function whose outcomes directly protect patients, maintain regulatory standing, and support the organization's mission of delivering high-quality, cost-effective care to Medicare Advantage-enrolled seniors.Job Profile Summary
The VP, Internal Audit is a highly visible senior leadership role responsible for directing the internal audit functionat Alignment Healthcare, Inc., with accountability for SOX compliance, enterprise risk management, and regulatory oversight across all business operations. This leader works in close partnership with the Audit Committee, CFO,CAO,executive leadership, legal, compliance, finance, and business unit leaders to strengthen the overall control environment and position internal audit as a trusted advisor-not merely a compliance function. Drawing on deepexpertisein Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces emerging risks, and ensures the organizationoperateswith the highest standards of accountability. This is a critical enterprise function whose outcomes directly protect patients,maintainregulatory standing, and support the organization's mission of delivering high-quality, cost-effective care to MedicareAdvantage-enrolled seniors.
Job Duties / Responsibilities
SOX Program Leadership & Internal Control Governance
Lead the design, execution, and continuous improvement of the company's SOX 404 program, including scoping, risk assessment, control design, testing, and documentation.
Drive governance over the outsourcedinternalaudit partner, holding them accountable for quality, timelines, and professional standards.
Ensureall SOX documentation and testing results are complete,accurate, and maintainedin accordance withPCAOB standards and internal policy.
Enterprise Risk Assessment("ERM")& Audit Planning
Overseesthe Company's ERM processbydevelopingandexecutinga risk-based annual audit plan that provides comprehensive coverage of financial, operational, IT, and regulatory risks across the organization.
Proactivelyidentifycontrolenvironment gaps and emerging risks before theyescalate, andcommunicate findings with timeliness and transparency to senior management and the Audit Committeewhen needed.
Medicare Advantage Regulatory Compliance Oversight
Assess compliance requirements specific to the Medicare Advantage regulatory landscape, including the Model Audit Rule, RADV readiness,andencounter data integrity.
Partner with compliance, legal, and actuarial leaders to ensure audit programs reflect current CMS regulations.
Control Deficiency Remediation & Management Accountability
Oversee the identification of root causes behind control failures,monitorremediation efforts, and hold management accountable fortimelyand durable resolution of deficiencies.
Deliver regular, clear status updates to executive leadership and the Audit Committee-translating complex audit findings into actionable business intelligence.
Operational Audit Leadership
Lead operational audits across all functional areas-finance, HR, claims, medical management, pharmacy, andtechnology-applyinga consistent, risk-basedmethodologyto evaluate process integrity andidentifyefficiency opportunities.
This includes overseeing IT general controls (ITGCs) and system-level controls related to ERP, claims, and data migration initiatives.
Control Culture & Business Partnership
Embed a culture of accountability by serving as a trusted advisor to business leaders on effective control design, helping them understand what "good" looks like in practice.
Move the organization from a compliance-driven mindset toone ofownership, where controls are embedded in daily operations rather than layered as an after-thought.
Audit Committee Engagement & Executive Reporting
Serve as the primary liaison to the Audit Committee Chair, providing regular reporting on audit results, risk exposure, program quality, and remediation progress.
Apply strong executive presence and communication skills to translate audit data into strategic insights for the Board and senior leadership.
Supervisory Responsibilities
This role carries supervisory responsibility over theCompany's third-party external audit team, including oversight of quality, work standards, timelines, reporting, and cost management.
Supervisory Requirements: Fulfill supervisory responsibilities in accordance with organization policies and applicable laws.Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Job Requirements
Experience
Required:
15+ years of progressive internal audit, external audit, or financial controls experience, with at least 5 years in a senior leadership role
8+ years of experience with a publicly traded company, including demonstrated knowledge of SEC reporting requirements and PCAOB auditing standards
Deepexpertisein Medicare Advantage plans, risk adjustment, and healthcare operations, including familiarity with CMS regulations, RADV, and the Model Audit Rule
Experience leading audit work in complex, regulatedhealthcareor insurance environments with strong emphasis on SOX and COSO framework application
Demonstrated experience directing and governing outsourced or co-sourced audit partnerships, including vendor management and quality oversight
Preferred:
Experience supporting Audit Committee reporting and direct interaction with Board-level governance bodies
Prior experience at a Big 4 public accounting firm or national advisory firm within a healthcare or managed care practice
Exposure to ERP implementation controls, data migration audits, and IT general controls in a healthcare setting
Education
Required:
Bachelor's degree in Accounting, Finance, Business Administration, or a closely related field
Preferred:
Master's degree in Accounting, Business Administration (MBA), or Healthcare Administration
Graduate coursework or certification in risk management, internal auditing, or healthcare compliance
Training
Required:
Ongoing professional development in internal auditing standards, including IIA (Institute of Internal Auditors) standards and the COSO Internal Control Integrated Framework
Demonstrated working knowledge of PCAOB standards, SEC reporting requirements, and SOX Section 404 implementation
Preferred:
Training in Medicare Advantageregulatory compliance, including CMS audit readiness, RADV methodologies, and encounter data management
Coursework or training in enterprise risk management frameworks (e.g., COSO ERM, ISO 31000)
Data analytics and audit technology training (e.g., ACL/Galvanize,TeamMate, or similar audit management tools)
Skills & Competencies
Technical / Role-Specific Skills
SOX 404 Program Management (Advanced):Demonstratedmastery of scoping, risk assessment, control design, testingmethodology, and PCAOB-compliant documentation across financial and IT controls
Medicare Advantage & Healthcare Regulatory Compliance (Advanced): In-depth knowledge of CMS regulations, risk adjustmentmethodology, RADV audit processes, encounter data integrity, and the Model Audit Rule as they apply to Medicare Advantage health plans
Enterprise Risk Management (Advanced): Ability to design and execute risk-based audit plans that address financial, operational, IT, and regulatory risks across complex, multi-functional organizations; fluency with COSO ERM framework
IT General Controls & Systems Audit (Intermediate to Advanced): Working knowledge of IT general controls, ERP control environments, data migration oversight, and systems implementation auditing-particularly in claims, pharmacy, and financial systems
Audit Committee & Executive Communication (Advanced): Exceptional written and verbal communication skills; ability to translate complex audit findings into concise, strategic narratives for Board-level and C-suite audiences whilemaintainingfull independence from management decision-making
Remediation Management & Root Cause Analysis (Advanced): Systematic approach toidentifyingroot causes of control breakdowns, designing corrective action plans, and driving sustainable resolution with measurable outcomes
Data-Driven Audit Analytics (Intermediate): Familiarity with audit analytics tools (e.g., ACL, IDEA, Tableau, or similar) to enhance audit coverage,identifyanomalies, and improve audit efficiency across large data sets common in healthcare and claims environments.
Licensure
Required:
No specific licensure is mandated; however, active professional standing in a recognized auditing or accounting credential is strongly expected at this level
Preferred:
Certified Public Accountant (CPA) - strongly preferred;indicatestechnical grounding in financial reporting, accounting standards, and attestation
Certified Internal Auditor (CIA) -preferred; the global standard for internal audit professionals,demonstratingproficiencyin IIA Standards, risk management, and governance
Certified Information Systems Auditor (CISA) -preferred, particularly given the IT controls and ERP oversight responsibilities of this role
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.Reasonableaccommodationsmay be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employeeis regularly required totalk or hear. The employee regularlyis required tostand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
The employeefrequentlylifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwiseparticipatingin the employee selection process, please contactcareers@ahcusa.com.
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER:Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related ...
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About Alignment Healthcare
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Orange, CA, US