Director of Internal Audit - Healthcare Compliance & Risk Management
il y a 6 jours
Melville
Job Description Our client is seeking a Director of Internal Audit to provide strategic leadership and oversight of the organizations internal audit function. This role is responsible for developing and executing a risk‑based annual audit plan, evaluating internal controls, ensuring compliance with federal and state healthcare regulations, and delivering independent, objective assessments to executive leadership. The Director partners closely with Compliance, Revenue Cycle, Finance, and operational leaders to strengthen governance, mitigate risk, and promote a culture of accountability and continuous improvement. Onsite | No Visa Sponsorship | No Relocation Assistance Responsibilities: Strategic Audit Leadership • Develop, own, and execute the annual Internal Audit Workplan, including audit scope, frequency, sampling methodology, and risk prioritization., • Lead risk assessments across operational, financial, and compliance areas to inform audit planning., • Oversee audits related to CMS, OIG, OMIG, and other regulatory bodies., • Ensure compliance with federal and state healthcare regulations, billing requirements, and documentation standards., • Direct audits involving CPT/ICD‑9/10 coding accuracy, medical record documentation, and billing integrity., • Oversee audit fieldwork, documentation, testing, and reporting., • Monitor corrective action plans and ensure timely remediation of audit findings., • Prepare clear, timely audit reports for Executive Leadership, Compliance Officers, and the CFO., • Partner with Compliance Officers on audits included in the Compliance Workplan., • Work closely with Revenue Cycle, Provider Enrollment, Managed Care, Informatics, and clinical leadership to ensure accurate billing, documentation, and regulatory adherence., • Lead, mentor, and develop internal audit staff; promote a culture of learning, accountability, and continuous improvement., • Build audit capacity across the organization through training, coaching, and process enhancement., • Perform additional duties as assigned., • Attend relevant conferences, workshops, and training sessions., • Strong analytical, investigative, and problem‑solving skills., • 5+ years of supervisory or leadership experience managing audit teams., • Excellent communication skills with the ability to present findings to senior leadership., • Proficiency in Microsoft Office (Excel, Word, PowerPoint) and audit documentation tools., • Bachelor's degree in Business Administration, Healthcare Administration, Accounting, or related field., • 10+ years of progressive internal audit or compliance experience, including 5+ years in healthcare auditing., • Strong knowledge of CPT codes, ICD‑9/10 coding, CMS guidelines, and healthcare billing regulations., • Deep understanding of federal and state compliance requirements (CMS, OIG, OMIG, Medicaid, Medicare), • Experience in medium-to-large healthcare systems or multi‑site organizations., • Certified Professional Medical Auditor (CPMA), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar credential., • Certified Internal Auditor (CIA), Certified in Healthcare Compliance (CHC), or related certification.