Senior Internal Audit Consultant - NCQA Accreditation

Company: Blue Cross Blue Shield of Alabama
Location: Birmingham
Posted on: May 16, 2025

Job Description:

Overview



Department Overview


Internal Audit and Compliance serves our Company and our customers by promoting integrity, efficiency and compliance with applicable standards, laws and regulations, and by systematically monitoring, evaluating and communicating risk in support of the Company's objectives.Plan Performance provides assurance on our product and service commitments by evaluating the timeliness, accuracy and delivery of our products and services to comply with requirements established by our customers, National Committee for Quality Assurance (NCQA) and the Blue Cross Blue Shield Association (BCBSA).
Primary Responsibilities


The Senior Internal Audit Consultant will be responsible for leading and monitoring NCQA Health Plan Accreditation. This includes monitoring and reporting of quality and/or performance indicators, identification of opportunities for improvement, conducting qualitative barrier analysis, collaborating with business areas to identify strategies for improvement and monitoring the impact of initiatives.The candidate should have knowledge related to quality standards and regulations including accreditation.The Senior Internal Audit Consultant will work collaboratively with the internal team to support research and analysis and incorporate policies and practices that ensure execution of a sound program. The consultant establishes and maintain partnerships with business areas and key personnel.The Senior Internal Audit Consultant assists with various functions within the area including:
* Reviewing the work of business areas to determine if work performed is accurate and sufficient to meet NCQA requirements and objectives
* Leading and performing operational audits and reviews of business activities and their compliance with applicable standards and regulations
* Planning, creating, organizing and documenting work papers
* Providing analyses, appraisals, recommendations, counsel, and information concerning activities reviewed
* Assisting all levels of management in the organization in the effective discharge of their responsibilities
* Providing guidance for and direct the work of others assisting with projects
* Leading and developing staff, projects, and resources
* Performing special projects as determined by the Department or Manager
* Participating in continuing education on audit methodologies, trends, professional standards, technological advances and Company processes
Summary of Qualifications

• Bachelor's Degree in Accounting, Finance, Healthcare Administration or other related business field
• Five years of experience directly related to financial and/or operational audit or consulting
• Interpersonal skills to work with technical and non-technical management and staff
• Strong experience working independently or as a team member to resolve problems without direct supervision
• Strong experience communicating effectively orally and in writing to document projects in a concise and thorough manner
• Excellent presentation skills
• Technical skills/programming aptitude in order to learn programming software
• Organizational skills necessary to manage multiple projects with various priorities
• Excellent interpersonal and leadership skills, with the willingness to negotiate and integrate conflict-management skills into challenging situations preferred
• Willingness to meet stringent deadlines and manage changing priorities preferred
• Experience with project management and continuous improvement preferred
• Knowledge of data analysis techniques and interpretation preferred
• Experience developing objectives, setting goals and facilitating plans to achieve desired results preferred
• Experience in a position leading large scale corporate projects or initiatives preferred
• Extensive experience with NCQA Health Plan Accreditation strongly preferred
• Certified Internal Auditor (CIA), Certified Fraud Examiner (CFE), Certified Public Accountant (CPA) or Certified Information Systems Auditor (CISA) certification preferred
  Work Location
  
  
  The work location for this position will be hybrid (onsite/remote)
  Terms and Agreements
  
  
  By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews. We appreciate your interest in Blue Cross and Blue Shield of Alabama 'The Company'. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.
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Keywords: Blue Cross Blue Shield of Alabama, Hoover , Senior Internal Audit Consultant - NCQA Accreditation, Professions , Birmingham, Alabama