Regulatory Audit Manager | Hybrid NYC

Description and Requirements

Healthfirst is subject to various recurring and ad hoc operational, financial and/or compliance examinations from a variety of State and Federal regulatory entities. The Regulatory Audit team within the Regulatory Affairs Department is the primary liaison between Healthfirst business areas and all external regulatory auditors and examiners, overseeing and coordinating Healthfirst's responses to ensure complete and timely submissions for all lines of business.

The Regulatory Audit Manager reports to the Director, Regulatory Audit with responsibility to:

• Project manage assigned engagements of all levels of complexity, ensuring deliverables are properly assigned and all appropriate levels of management are aware of the obligations.
• Ensure deadlines are communicated and followed up on to ensure dates are met.
• Correspond with, and act as the single point of contact (SPOC) for, State & Federal examiners to ensure any questions are addressed and the requirements are understood by all stakeholders.
• Prepare business areas and all levels of personnel for upcoming external audits, including but not limited to audit basics, expectations, coordinating & facilitating education sessions, etc.
• Collaborate with Regulatory, Compliance and business areas to identify, assess and communicate audit risk ahead of upcoming examinations.
• Facilitate and provide guidance on corrective action responses to examination findings and collaborate with Compliance to ensure appropriate processes and controls are documented to address risks and deficiencies.
• Identify opportunities and collaborate with team members to implement best practices in audit and project management, including standardization of project documentation maintenance and accessibility, documentation of recurring audit processes to ensure repeatability, development of management reporting, and policy & procedure documentation.
• Contribute to Executive and Board-level reporting on audit status and potential risks.

• Prior audit project management experience, preferably with a health insurer.
• Bachelor's degree from an accredited institution with a concentration in Finance, Business Management, or a Health Management related field.
• Ability to work with all levels of management.
• Solid professional writing skills.
• Critical and analytical thinking, and problem-solving skills.

• Experience or familiarity coordinating regulatory-based financial audits pertaining to New York insurance law and regulation.
• Experience in Medicare and Medicaid health insurance preferred.
• Experience working with eGRC application(s), implementation experience a plus.
• Direct experience conducting regulatory audits with such agencies as CMS, DFS, DOH, DMAHS, IPRO, OMIG and other regulatory bodies highly preferred.