The Compliance Operations Auditor reports to the Director of Compliance. This position is responsible for conducting comprehensive internal audits and reviews of Central Health’s diverse operational processes. This role  ensures robust compliance with applicable laws, regulations, and internal policies, while also assessing adherence to established performance standards. The Operations Auditor plays a critical role in supporting the organization's mission by proactively identifying potential risks, rigorously evaluating the effectiveness of internal controls, and developing actionable recommendations that strengthen accountability, enhance efficiency, and ensure comprehensive compliance across all departments. This position is instrumental in cultivating a culture of continuous improvement and operational excellence throughout Central Health’s administrative functions, including but not limited to finance, procurement, human resources, and technology. Key responsibilities also include active participation in the development of the organization's annual audit plan, meticulous execution of assigned audit tasks to ensure satisfactory outcomes, and thorough documentation of audit findings and evaluations. This role is crucial for maintaining the integrity and effectiveness of the organization's operations and financial reporting. The ideal candidate will be detail-oriented, possess a strong analytical mindset, and demonstrate an unwavering commitment to upholding the highest standards of compliance and control.

Essential Functions:

• Conducts in-depth internal audits to systematically assess the effectiveness of internal controls, accuracy of operational processes, and overall efficiency across various functional areas.
• Performs rigorous audits of vendors to ensure strict adherence to contractual obligations, conflicts of interests and regulatory requirements.
• Performs audits of Employee and Board of Manager files, ensuring strict adherence to privacy regulations, conflicts of interests and regulatory requirements.
• Leads internal audits related to Fraud, Waste, and Abuse (FWA) and analyzes delegated oversight policies, providing evidence-based recommendations for process improvements and changes consistent with all applicable state and federal regulations and guidelines.
• Analyzes complex operational and financial data to identify and report patterns indicative of fraud, waste, and/or abuse; evaluates results from prior audits to discern FWA trends and proposes proactive preventative and corrective actions.
• Translates complex fraud, waste, and abuse information into clear, concise, and easy-to-understand communications for diverse stakeholders, ensuring effective message delivery both verbally and in writing.
• Continuously monitors changes in relevant laws, regulations, and industry standards, maintaining up-to-date knowledge of best practices in audit methodologies and internal controls.
• Actively contributes to the development and strategic implementation of robust risk management strategies across the organization.
• Develops and recommends impactful improvements to policies, procedures, and systems designed to enhance the overall internal control environment.
• Prepares comprehensive monthly reports detailing audit findings, activities, and recommendations for executive leadership.
• Performs other duties as assigned to support the operational auditing function and organizational objectives.
• Prepares monthly reports of audit findings/activity.
• Other duties as assigned.

Knowledge, Skills and Abilities:

• Thorough familiarity with Sarbanes-Oxley Act (SOX) requirements and other relevant regulatory frameworks (e.g., HIPAA, state public information acts).
• Comprehensive knowledge of audit methodologies, including risk assessment, sampling methods, and internal control testing.
• Solid understanding of both internal and external audit processes and their interdependencies. 
• Knowledge of industry-specific regulations, such as those pertaining to healthcare, finance, or government sectors. 
• Understanding of IT systems, databases, and software relevant to financial reporting and auditing. 
• Strong analytical skills with a proven ability to analyze complex operational and financial data, identify discrepancies, discern trends, and assess associated risks. 
• Proficiency in conducting root cause analysis and formulating practical, effective corrective actions. 
• Knowledge of cybersecurity risks and controls, data privacy regulations, and IT governance frameworks. 
• Knowledge of common fraud schemes and red flags. 
• Skilled at managing high functioning interdisciplinary teams of professionals. 
• Excellent organizational skill with the ability to manage multiple priorities. 
• Knowledge of applicable state, and federal regulations. 
• Ability to take initiative and meet deadlines. 
• Ability to exercise sound judgment and maintain objectivity and integrity throughout the audit process. 
• Proficient use of Microsoft Office 365 suite, particularly SharePoint, Visio, Excel, and Microsoft Project. 
• Ability to effectively use audit software and tools, such as ACL, IDEA, or Excel, to perform data analysis and audit testing. 
• Exceptional written and verbal communication skills to clearly articulate audit findings, recommendations, and reports to diverse audiences, including senior leadership. 
• Maintain attendance to support required quality and quantity of work. 
• Maintain positive and effective work relationships with coworkers, clients, members, providers and customers. 
• Other duties as assigned.

Minimum Experience:

• Bachelor's Degree (higher degree accepted) in accounting, finance, public administration, business or related field

Minimum Experience:

• 7 years Progressive and comprehensive audit experience, preferably in internal audit or public accounting