Lead Auditor – IDR Entity Audit

📋 Description

• Conduct audits in a consistent, unbiased, and objective fashion across all certified IDR entities.

• Oversee project audit teams, including delegating tasks, providing mentorship, and reviewing the work produced by junior auditors.

• Manage and ensure the timely completion of assigned tasks for both standard and expedited audits.

• Maintain quality control over audit documentation, evidence, findings, and recommendations to guarantee that each audit is thoroughly documented and defensible.

• Evaluate the project team’s audit documentation, including the evidence that supports eligibility and payment determination findings, as well as the rationale presented in draft audit reports.

• Offer technical support to CMS and project personnel regarding audit methodologies, which encompasses statistically representative sampling design, the handling of single versus batched disputes, reopened determinations, and evaluations of clerical, procedural, or jurisdictional errors.

• Review audit reports and other deliverables while engaging with the client on programmatic and technical matters, including the Audit Strategy, individual audit reports, and both the Preliminary and Final Annual Audit Reports.

• Utilize knowledge of Generally Accepted Accounting Principles (GAAP), Government Auditing Standards (GAS), and pertinent Federal regulations—along with relevant industry practices—in each engagement.

• Evaluate certified IDR entity compliance with eligibility determination criteria (such as batching, State All-Payer Model Agreements, and applicable State laws), payment determination processes, recordkeeping, and reporting timelines.

• Detect recurring issues, emerging trends, and potential “red flags” for escalation; assist in calculating financial impacts (e.g., collected but unremitted administrative fees) when necessary.

• Protect sensitive healthcare data and ensure that audit execution adheres to the No Surprises Act, 45 CFR 149.510, and all contractual security and privacy protocols.

⛳️ Requirements

• At least seven (7) years of relevant experience managing performance audits or programs related to enrollment data, as well as auditing financial information and payments.

• Active CFE (Certified Fraud Examiner) and/or CPA (Certified Public Accountant) certification is required.

• Proven experience in reviewing junior auditors’ work and leading teams of multiple auditors.

• Familiarity with GAAP, Government Auditing Standards (Yellow Book), and Federal regulatory frameworks pertinent to healthcare audits.

• Excellent written communication skills, including the ability to compose and review audit findings, workpapers, recommendations, and corrective action narratives suitable for publication on the CMS No Surprises Act website.

• Bachelor’s degree in accounting, finance, healthcare administration, or a related field is required; an advanced degree is preferred.

• Availability and commitment to serve in the Key Personnel role for the entire duration of the project; a signed commitment letter will be necessary at proposal submission for any candidate not currently employed by the prime contractor or a proposed subcontractor.

• Capability to obtain and maintain any required CMS security and privacy clearances, as well as complete CMS-mandated training.

🏝️ Benefits

• Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).