Audit Manager

State of North Carolina
Published
April 16, 2019
Location
North Carolina, NC
Job Type

Description

Description of Work

This position is exempt from the State Human Resources Act**
This posting is pending anticipated vacancy

Position Summary

This Audit Manager will manage a team of auditors and paraprofessional staff and resources in the planning and execution of desk reviews, field audits, settlements, data analysis, and reconciliation activities on annual Medicaid and NC Health Choice cost reports, including but not limited to hospitals, long term care facilities and state owned/operated institutions. Additionally, this position will direct and manage the same staff and audit resources in their transition to financial oversight and monitoring teams of Managed Care entities. This position will assure all assigned audits and monitoring activities are completed within establish deadlines and in compliance with federal and state regulations, N.C. State Plan, Provider Participation Agreements, and the Medicaid Managed Care 1115 Waiver and Contracts.

Job Specific Responsibilities

  • Plan, coordinate and supervise audit, review, monitoring, and settlement activities for assigned team.
  • Provide ongoing supervision, training, and guidance to staff (organizing, directing and monitoring work; setting priorities and goals, making hiring decisions)
  • Understand the appropriate regulatory guidance for each audit and provider type.
  • Monitor staff and ensure audits are completed accurately and efficiently
  • Issue audit reports in accordance with state and federal guidelines as well as GAAP and GAAS
  • Recommend to management as appropriate when audit findings warrant changes to the State Plan or policy
  • Determine if audit findings warrant referral to Division of Health Benefits Program Integrity or NC Department of Justice Medicaid Investigations Unit
  • Represent the DHB Audit Section in any appeals of these audits

The North Carolina Medicaid and NC Health Choice programs (NC Medicaid), managed by the Division of Health Benefits (DHB), helps North Carolinians improve their health and well-being by providing access to services and supports for low-income parents, children, seniors, people with intellectual / developmental disabilities, behavioral health needs or substance use disorders. With a budget of more than $14 billion per fiscal year, Medicaid ensures that 69,000 enrolled providers are reimbursed for delivering covered services to more than two million beneficiaries.
On Sept. 23, 2015, the North Carolina General Assembly passed Session Law 2015-245, as amended, directing NCDHHS and DHB to lead the transformation of the Medicaid and NC Health Choice programs from a predominantly fee-for-service delivery system to managed care.
Knowledge, Skills and Abilities / Competencies

Qualified Applicants Must Document On The Application That They Possess All Of The Following

To receive credit for all of your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit.

  • Strong leadership capabilities as demonstrated through effective management of financial programs or similar functions
  • Demonstrated ability to plan and organize work and effectively supervise multiple personnel with diverse skill sets, and the ability to mentor new employees
  • Thorough knowledge of Generally Accepted Accounting Principles (GAAP) and Generally Accepted Auditing Standards (GAAS)
  • Proven ability to understand, interpret, and apply complex State and Federal regulations
  • Thorough knowledge and use of Microsoft Excel, Word, and Access
  • Demonstrated ability to communicate professionally in oral and written form with key stakeholders (i.e. Providers).
  • Demonstrated initiative and proven ability to act independently and exercise judgment to produce results, frequently under time constraints

Management prefers

  • Two or more years in supervision of three or more audit staff.
  • Accounting experience in the preparation of interpretive or analytical accounting/financial statements and reports
  • Experience in financial monitoring / audit of Medicaid / Medicare Managed Care organizations
  • Knowledge of Medicaid and/or Medicare cost reporting forms and Medicaid/Medicare programs and cost reimbursement principles
  • One or more years of Public Accounting experience
  • Certification/licensure as a certified public accountant, certified internal auditor, certified fraud examiner or related certification or licensure

Minimum Education And Experience Requirements

Bachelor s degree in accounting, business, finance or other discipline related to the area of assignment with 12 credit hours of accounting coursework from an appropriately accredited institution and three years of related professional experience, of which two years is audit experience;
or
Bachelor s degree in any field from an appropriately accredited institution and certification/licensure as a certified public accountant, certified internal auditor, certified fraud examiner, certified information system auditor; or related certification/license and three years of related experience including two years of audit experience; or an equivalent combination of education and experience.
Supplemental and Contact Information

The North Carolina Department of Health and Human Services is an Equal Opportunity Employer.

Pre-Employment criminal background checks are required for all positions with the Division of Health Benefits.

Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. You will either receive a call to schedule an interview or an email notifying you when the job has been filled.
For technical issues with your application, please call the NeoGov Help Line at click apply Applicants will be communicated with via email only for updates on the status of their application. If there are any questions about this posting other than your application status, please contact HR at click apply.

For Permanent Appointments
State of North Carolina employees have the opportunity to participate in a compelling array of benefits to enhance their quality of life, their health, and their future. Benefits include employee health insurance options, standard and supplemental retirement plans, NC Flex (a variety of high-quality, low cost benefits on a pre-tax basis), and paid vacation, sick, and community service leave, to name a few. Some benefits require 30 + hours work/week for participation. To find out about these, and other programs, please visit our Employee Benefits page:

For Temporary, Contract Or Other Supplemental Staffing Appointments

**There are no paid leave, retirement or other benefits associated with these appointment types.**

 

 

Company Description

Whether you are interested in the arts, transportation, IT, the environment, public safety, healthcare or countless other areas, the State of North Carolina has an opportunity for you.

North Carolina State Government employs more than 81,000 people across the state in various agencies, branches and universities. Our careers are as diverse as the citizens we serve! We are seeking skilled and dedicated individuals from a wide range of educational and experience backgrounds.

Governor Roy Cooper believes in the potential of our great state and its people. He knows that we can build a state and an economy that work for everyone. By investing in our public schools and giving students the tools they need to succeed, creating good jobs and raising incomes for the middle class, and strengthening our communities, North Carolinians can live and work in places they are proud to call home.

Working for the State of North Carolina can offer you the chance to effect positive change for our residents and visitors, take advantage of numerous benefit options and advancement opportunities, and work in an environment that values collaboration, creativity, innovation and diversity. Learn more about state government jobs at https://www.governmentjobs.com/careers/northcarolina.

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