• Internal Audit Program Manager - Compliance Department (San Diego, CA), Full-time

    Rady Children's Hospital San DiegoSan Diego, CA 92108

    Job #1379237668

  • JOB SUMMARY:

    Reporting to the Chief Compliance & Privacy Officer and in collaboration with the applicable executive and/or committee, coordinates the development of a risk-based internal audit plan to identify and evaluate key business practices, financial processes and controls, operational areas and information technology and related security activities. Provides project management to the Internal Audit team throughout execution of the annual internal audit plan. Works closely with the internal audit function and activities and ensures the timely and accurate completion of all assignments and reporting, including working closely with audit and compliance leaders for accurate and timely review of documentation and reporting to the applicable executive and Board committees. Works with the Chief Compliance & Privacy Officer in the continuous assessment, development and maintenance of a comprehensive compliance program audit plan approved by the Executive Compliance Committee and, as needed, the Board Audit and Corporate Responsibility Committee. Provides direct support to the Chief Compliance & Privacy Officer and applicable executives toward effecting ongoing operation/ enhancement of audit and compliance activities including coding, billing, clinical record documentation, clinical trials, reimbursement, legal and financial imperatives/projects and processes. Acts as a Compliance Department subject matter expert on billing and revenue

    compliance matters. Works closely with Coding Compliance Manager, Hospital Revenue Cycle, Provider Billing, HIM and clinical teams, as needed, to support the design of processes to meet regulatory requirements, and implements ongoing risk assessments and monitoring techniques. Prepares written reports to document revenue cycle, coding and billing audit and compliance risk assessments, observations, corrective actions and timeliness, and specific recommendations to improve internal controls and mitigate risks.

    MINIMUM QUALIFICATIONS:

    Bachelor's Degree

    Area of Study in a Field Related to the Position

    5 Years of Experience

    Working knowledge of major business processes and compliance/risk areas related to the healthcare industry

    Knowledge of generally accepted auditing standards, financial and operational auditing techniques,computerized records and control systems, and enterprise risk and compliance program frameworks

    Strong project management skills. Ability to effectively organize, prioritize, multi-task and manage audits, projects and time to meet demanding timelines

    Ability to communicate and collaborate on complex and potentially sensitive issues with all levels of management. Excellent analytical, oral and written communication skills

    Experience in developing educational materials and conducting presentations

    Ability to write and implement policies and procedures

    Broad-based knowledge of data processing systems and applications, including proficiency inMicrosoft applications (Word, Outlook, Excel, PowerPoint, SharePoint), as well as ability to

    manipulate data and recognize and track trends

    Ability to work with minimum supervision

    PREFERRED QUALFICATIONS:

    8 Years of Experience

    Minimum two years of healthcare auditing experience in highly regulated industry

    5-8 years of health care regulatory, auditing, ethics, compliance experience, or any combination of education and experience, which would provide an equivalent background

    Strong understanding of healthcare industry and its risk areas and compliance requirements

    Project management experience

    At least 1-3 years supervisory/management experience in healthcare or other highly regulated industry

    Certified Internal Auditor or Certified in Healthcare Compliance (CHC)

    JOB DETAILS:

    Schedule: Days

    FTE: Full-time (1.0FTE), Benefits Eligible

    Location: Main - Nelson Building (San Diego, CA)

    #SJ #AH

    EOE including disability/vet