Senior Insurance Manager, Internal Audit

Mass General Brigham (Enterprise Services)
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
May 02, 2025
1.Identify and assess entity risks. 2.Develop/Assist in developing and maintaining an audit plan that supports MGB HP's and MGB's strategic plan and internal control needs. 3.Plan, conduct, manage and supervise financial/regulatory/operational audits and special projects as well as make internal control recommendations during audits/projects, including discussion of audit matters with Department and Entity management. 4.Provide management with Model Audit Rule support. 5.Provide consultation to the Medicare Advantage and other government compliance auditors in the MGB HP Legal Regulatory Affairs and Compliance department. 6.Present to Senior Management cost effective recommendations for improving controls and operating efficiency in key areas of the company. 7.Assist in developing internal audit (IA) procedures to ensure consistent application of IA policy. 8.Make recommendations on projects/activities, follow up and monitor the implementation of Audit Recommendations. 9.Prepare quarterly Audit & Compliance Committee reports. 10.Attend/Present key audit findings and recommendations, including status of prior Audit recommendations at quarterly Audit Committee (AC) meetings. 11.Manage the day to day operations of the Internal Audit Services Insurance Operations Internal Audits, including: Plan, conduct, coordinate and supervise a variety of value added reviews, including reviews of business processes; maintain and review comprehensive files on the work conducted and findings noted; discuss audit findings with auditees; prepare audit/other reports; Communicate audit/other results to management; and ensure that recommendations are complied with. 12.Participate in management requested special projects to help resolve exceptional company challenges. 13.Oversee the appropriate and timely completion of follow-up audits. 14.Supervise the day to day activities of audit staff, and conduct appraisals of audit, using MGB HR guidelines (no current staff at this time). Education: BS/BA in Accounting or related field from an accredited school Experience: 5-7 years of experience in auditing (healthcare experience/healthcare insurance company experience). CPA/CIA and/or advanced degree are a plus. Advanced knowledge of the operation, procedures and policies of assigned business units. Strong familiarity with their specific business processes and transactions. Strong knowledge of generally accepted auditing standards, IIA standards, accounting and auditing sampling and testing methodologies, Model Audit Rule or Sarbanes Oxley requirements, risk management and statutory reporting. Knowledge of regulatory requirements of the Medicare Advantage and Part D insurance programs. Ability to identify risk areas and develop and execute on audit plans to address Medicare Advantage and Part D program risks is a plus. Information system audit experience and experience using Artificial Intelligence during audits is a plus. Demonstrate self-initiative, be proactive and collaborative, and have comfort working in a high-performing environment, able to adapt to changing needs and priorities. Advanced communication (oral and written) and interpersonal skills are also required to effectively communicate, interact, and build strong working relationships with various process owners and senior management. A service-focused attitude is essential. The ability to work with large amounts of data and perform analyses is strongly desired. Demonstrate Mass General Brigham Health Plans' core brand principles of always listening, challenging conventions, and providing value. Management experience. Strong relationship management skills working with key business clients and executive level management Audit Skills: Ability to evaluate risks in order to develop and manage an annual audit plan under the direction of department leadership and in cooperation with the senior management of the company Ability to plan, coordinate, and direct the activities of others in order to accomplish predetermined objectives. Ability to train and supervise Auditors in the principles of internal auditing standards. Demonstrated ability to motivate staff. Strong technical skills in the fields of accounting and internal audit and obtain a comprehensive understanding of the company's operations and strategic objectives. Ability to conduct oneself in a manner appropriate to the situation and individuals involved Ability to communicate effectively (both oral and written) with auditees and Senior MGB management. Ability to establish priorities and anticipate problems. Other Details: Hybrid Schedule, 1-2 days per week in office at Assembly Row No direct reports; may indirectly provide leadership and guidance to less seasoned and new staff No direct budgetary responsibility Demonstrates fiscal responsibility by effectively using Mass General Brigham resources Work is normally performed in a typical office work environment. Position is based in Assembly Row, Somerville, MA in a building which is T-accessible. Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.