Managed Care Audit Manager

Role Overview

• Lead and manage multiple audit engagements from planning through reporting and follow-up.
• Develop audit work plans, risk assessments, and testing methodologies.
• Ensure compliance with applicable federal regulations, program guidance, and Government Auditing Standards (GAGAS).
• Supervise, mentor, and evaluate audit staff.
• Review workpapers, findings, and reports for accuracy, quality, and adherence to standards.
• Communicate audit results and recommendations to senior leadership and external stakeholders.
• Identify emerging risks and recommend process improvements.
• Support continuous enhancement of audit methodologies and internal quality controls.

Requirements

• Minimum of three (3) years of management experience in the auditing field.
• Demonstrated knowledge of federal healthcare programs, related regulations, manuals, coverage and payment rules, and Government Auditing Standards (GAGAS).
• Experience auditing managed care or health plan organizations preferred.
• Bachelor’s degree in accounting or equivalent from an accredited institution required.
• Master’s degree preferred.
• Current Certified Public Accountant (CPA) license required.
• Strong leadership and team management skills.
• Advanced knowledge of audit principles, risk assessment, and internal controls.
• Excellent analytical, organizational, and problem-solving abilities.
• Strong written and verbal communication skills.
• Ability to manage competing priorities in a deadline-driven environment.