Special Investigations Unit Audit Senior Consultant

Company Description

The Blue Cross and Blue Shield Association (BCBSA) is a national federation of independent, community-based, and locally operated Blue Cross and Blue Shield companies. Collectively providing health care coverage for one in three Americans, BCBSA offers vital health care insights through The Health of America Report series and the national BCBS Health Index.

Role Description

This is a full-time role for a Special Investigations Unit Audit Senior Consultant. Responsibilities includes: conducting audits and ensuring compliance with federal contracts, legal mandates, and internal guidelines to prevent fraud, waste, and abuse (FWA). Supports the Special Investigations Unit (SIU) in handling internal and governmental audits, providing analysis and recommendations based on audit findings, and preparing reports on compliance activities. Provide compliance SIU contractual guidance and deliver compliance training. Participates in workgroups and delivers clear, concise reports to management and stakeholders at all levels. This is a hybrid role based in Washington, DC, with opportunities for some remote work.

Qualifications

• Experience in conducting audits, analyses and compliance assessments in the regulated industry, familiarity with accounting and audit standards, and comprehensive knowledge of audit techniques.
• Skilled in audit and compliance assessment in the regulated industry, familiarity with accounting and audit standards, and comprehensive knowledge of audit techniques.
• Demonstrated ability to communicate effectively, orally and in writing, with excellent interpersonal and customer service skills.
• Demonstrated problem-solving skills and use of inductive and deductive reasoning to propose solutions for audit and compliance findings or issues. Analytical and critical thinking skills are essential to exercise independent judgment.
• Build relationships with internal and external stakeholders and convey a sense of professional confidence.
• Ability to prepare various reports and analyses to support audit findings.
• Knowledge of data, financial, research, and Fraud, Waste, and Abuse (FWA) analysis techniques and proactive software applications. Ability to research, analyze, and apply data/information accurately with attention to detail and accuracy with large data sets.
• Excellent organizational and time management skills.
• Knowledge of federal government investigative agencies is a plus.
• Ability to work independently and collaboratively in a hybrid work environment
• Bachelor's degree in a relevant field such as Business, Accounting, Finance, or Health Care Administration
• Experience with regulatory compliance and health care laws is a plus