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Blue Cross Blue Shield of Massachusetts Audit Manager, Audit and Risk Management - Health Care in Boston, Massachusetts

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The Audit and Risk Management area assists management in identifying, evaluating, and mitigating operational, financial, and strategic business risks. As a valued member of the Internal Audit, within the Audit, Risk Management and Information Security (ARMIS) Division, this position will provide leadership and expertise in the development and execution of Model audit rule (MAR), which is similar to Sarbanes-Oxley, Service Organization Control 1 and 2 (SOC1 and SOC2) type 2 audits, and operational readiness and business risk assessments. The position may include facilitation of some external audits including those of our Pharmacy Benefit Manager (PBM). Additionally, this position may also facilitate the execution of audits performed by external parties, such as Division of Insurance, Centers for Medicare and Medicaid Services, Federal Employee Program Directors’ Office, Blue Cross Blue Shield Association, and others.

Responsibilities:

  • Ensures that MAR, SOC1 and SOC2, and focused audit work meets applicable internal and external audit standards and established deadlines

  • Works independently and as leader of staff/team to complete MAR, SOC1, SOC2.

  • Designs and assigns staff to projects based on strengths, knowledge, and development needs.

  • Able to understand broader implications of a project or issue across stakeholder areas.

  • Oversee the timely completion of portfolio of audits as assigned

  • Prepares or leads complex financial, operational and IT projects and risk assessments to provide risk assurance to key initiatives

  • Determines objectives of, and approaches to, significant organizational projects or assignments

  • Prepares high quality audit communications, reports and supporting documentation, and provides value-added recommendations that promote effective and efficient solutions to business risks

  • Contributes to periodic reporting to the Audit Committee

  • Evaluates potential impact of changes to the control environment

  • Assists in developing control consciousness throughout the business

  • Participation in corporate committees (including Fraud Waste and Abuse committee, Corporate Data Standards Committee, and others as applicable)

  • Influences others by communicating thoughts and recommendations with confidence verbally and in writing

  • Ability to clearly and concisely report on issues and areas that need to be addressed by the business. Contributes to audit committee and other communications.

  • Builds relationships with peers, business leads, direct reports, and external auditors by inspiring trust through consistent performance

  • Participates in professional development and recruiting activities

Education & Qualifications:

Ideal candidates meet the following qualifications:

  • Bachelor’s degree and 5 or more years’ audit experience; Master’s degree preferred

  • CPA Certification is required; CIA and/or CFE is a plus

  • Healthcare or insurance industry preferred

  • Working knowledge of/experience with general internal control requirements, and general understanding of business operations, financial and information technology procedures and controls

  • Working knowledge of/experience with NAIC Model Audit Rule testing (similar to Sarbanes-Oxley)

  • Demonstrated initiative and ability to handle a high workload in a fast-paced environment.

  • Ability to independently interact with senior levels of management

  • Ability to develop and maintain positive working relationships with peers, leaders and external parties

  • Ability to work independently and as part of a project team

  • Ability to drive team and others to take initiative in overcoming obstacles and develop alternative approaches to achieving the right outcome

  • Excellent communication, analytical and problem-solving skills

  • Proficient with Microsoft Office applications including Word, Excel, Access, Power Point, and Visio. ACL experience is a plus.

  • Experience with data visualization tools (Tableau, Power BI, others) and/or SAS programming language for data extraction and manipulation is preferred but not required.

Minimum Education Requirements:

High school degree or equivalent required

LocationBostonTime TypeFull time

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. We provide a flexible hybrid work model in which roles are designated as resident (on site 4-5 days/week), mobile (on site 1-3 days/week), or eworker (on site 0-3 days/month).

Blue Cross Blue Shield of Massachusetts, has a COVID-19 vaccination requirement for building entry. Your offer of employment is dependent upon either being fully vaccinated for COVID-19 or an accommodation based on a disability or sincerely held religious belief, practice, or observance by submitting a request to Human Resources.

Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power , Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates.

Our Commitment to You

We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance.

Blue Cross Blue Shield of Massachusetts is an Equal Employment / Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.

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