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Manager - Audit & Advisory Services (Medicaid Government Com

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Job Details
Job Order Number
Company Name
Highmark Health
Physical Address

Wilmington, DE 19806
Job Description

Company :

Highmark Inc

Job Description :


+ The Medicaid Government Compliance department partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental and contractual entities. Additionally, Medicaid Government Compliance continuously monitors regulatory requirements and helps the organization to accomplish its objectives by bringing a systematic, disciplined approach to evaluating and improving the effectiveness of risk management, control and governance processes by providing insight and recommendations based on analyses and assessments of data and business process. Medicaid Government Compliance also leads any regulatory external reviews such as External Quality Reviews (ERQ) & Information Systems Capability Assessments (ISCA).

+ The Manager, Audit & Advisory Services is responsible for managing the execution of a comprehensive audit program for the Medicaid organization as well as participate in the creation of an annual audit plan. This includes monitoring regulatory requirements and conducting internal audits and assessments in a manner in which all relevant risks are assessed in an efficient manner to determine completeness, accuracy, validity, and effectiveness of the business model. The Manager would also would be the lead and point of contact for all external reviews.


1. Audit & Advisory Engagement Management – Provide leadership role and collaborate with the Director and other members of the team and business owners to plan and execute audit and advisory engagements in an efficient and effective manner.

+ Demonstrate and apply a thorough understanding of complex financial and operational processes and/or complex information systems at the Company.

+ Stay abreast of changing Institute of Internal Auditor standards and leading audit practices, as well as current business and industry trends relevant to internal clients.

+ Effectively manage assigned engagements on the Internal Audit & Advisory Services Plan, by addressing delays and removing barriers, as necessary. Propose modifications to the Internal Audit & Advisory Services Plan based on evolving priorities, largely driven by enterprise and tactical risk evolution.

+ For each assigned engagement:

+ Plan the risk assessment, and develop work program timelines, scoping, materiality and other planning documents.

+ For audit engagements, perform the selection of items or controls to test to satisfy the audit risk and provide appropriate level of independent assurance.

+ For advisory engagements, collaborate with business owners to analyze, evaluate, and enhance business process controls and/or information system functionality facilitating the assessment and mitigation of strategic, financial and operational risks. This includes managing the creation of process documentation (narratives, flows, etc.), risk assessments, control design evaluations, and control implementation validation.

+ Identify barriers to successful engagement completion and execute strategies to ensure that milestones are achieved while adhering to strict deadlines.

+ Execute engagements on time and in accordance with the budget in an effective and efficient manner.

+ Identify, evaluate, prioritize, and consult the business to remediate control findings and control deficiencies as identified, including the approval of remediation plans.

+ Consistently deliver high quality client services.

+ Perform detailed reviews (Quality Control procedures) of Internal Audit & Advisory Services team member work, including risk assessments, testing, and analyses.

+ Materially contribute to the development and maintenance of the Internal Audit & Advisory Services Plan. Identify and track new engagement opportunities by investigating and determining the appropriate customers and validating the value and appropriateness of the engagement.

+ Maintain department systems including oversight of the integrity of the engagement documentation software and issue repositories.

+ Manage the completion of remediation efforts and perform timely follow-up audits, as necessary.

+ Lead special projects requested by management or the Audit Committee of the Board of Directors. These priority projects are generally highly confidential and sensitive and require the utmost discretion in the conduct of the work. These assignments require solid investigative and analytical skills to perform the review, sound judgment to reach conclusions, and solid business sense to recommend practical corrective actions. These projects generally require analyzing issues from a variety of internal and external sources that may relate to a variety of underlying issues including operational efficiencies, cost containment or reduction, and compliance with governmental regulations.

+ Prepare and provide status reporting to the team, Director, and Vice President on a recurring scheduled basis and as necessary.

2. Partnership & Communication

+ Interact and maintain productive business relationships with business leaders and individual contributors at all levels. Collaborate with these business partners and staff on solutions to support effective and efficient execution of audit and advisory engagements.

+ Be a valued business partner worthy of providing feedback and consultation related to existing or emerging internal controls, compliance matters, and audit findings.

+ Coordinate the work of not only the Internal Audit & Advisory Services department, but also the parts of audit work staffed by Technology Audit & Advisory Services (TAAS) to ensure that audit and advisory engagements as a whole are effective and well executed. This involves regular interactions with management in the TAAS department to ensure that their efforts are consistent (time and scope) with the Internal Audit & Advisory Services Plan for shared engagements and will lead to successful completion of the integrated engagement.

+ Collaborate with the Governance, Risk and Controls department on control design and testing to ensure appropriate procedures are performed to determine with reasonableness assurance the design and operating effectiveness of Model Audit Rule, SSAE16 and new process key controls, while improving the customer’s experience through effective engagement coordination.

+ Collaborate with the Enterprise Risk Management department to maintain an understanding of enterprise risks, tolerance levels, and risk mitigation strategies for use in developing the Internal Audit & Advisory Services Plan.

3. People

+ Contribute to positive business results by maintaining a workplace characterized by high performance, mutual support and respect.

+ Demonstrate behavior to continually improve results by maintaining a positive work environment, which encourages team members to make meaningful contributions to the success of the department’s efforts.

+ Establish direction and motivate team members, creating an atmosphere of trust, leveraging diverse views, and encouraging improvement and innovation.

+ Provide training, direction and feedback to team members, and provide accurate and meaningful feedback throughout the year and during the annual performance appraisal process to assist employees in developing to their fullest potential and for career progression.

+ Promote team development and training through mentoring and coaching activities.

+ Proactively identify opportunities to challenge the competency of team members by providing stretch assignments and growth opportunities.

+ Establish an effective succession plan for key positions in the department.

+ Deliver and/or develop technical content (i.e. work programs, practice aides, and trainings)

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