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Audit Specialist (Compliance Consultant)

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
The Audit Specialist will be a part of the Medicaid Operations Integrity team. This exciting role will be instrumental in supporting:
  • End-to-End testing, across multiple segment and enterprise functions, to support operational effectiveness and regulatory compliance for Medicaid new business implementations and strategic initiatives
  • Medicaid operational sustainability reviews to ensure continuous end-to-end compliance and business optimization which will further strengthen relationships with our constituents
  • Ad-hoc audit and compliance projects will also be expected

Fundamental Components:
Primary responsibilities include:
  • Participating in cross functional process walkthroughs, along with the Medicaid Operations Integrity team, to determine audit and testing scope
  • Developing robust audit test plans that support the mitigation of financial and/or operational risks
  • Determining the sample selection methodology for testing
  • Conducting audit testing and preparing acceptable work papers by researching, compiling, and analyzing data
  • Effectively communicating the results of testing by documenting complex audit findings and final report
  • Conducting follow up testing to validate management’s mitigation of issues identified in initial testing
  • Supporting the Operations Integrity testing project plan (critical milestones and timelines) on schedule
Other Responsibilities include:
  • Supporting moderately complex business process reviews, corrective actions and other projects involving internal and external constituents
  • Assisting in the development / maintenance of Operations Integrity methodology (i.e., templates and work papers) and procedures
  • Maintaining positive and productive relationships with internal and external constituents and effectively communicating and influences ethical and compliant outcomes at various levels necessary to accomplish goals
  • Applying industry and audit / compliance knowledge to support and manage moderately complex matters involving Medicaid operations and regulatory requirements
  • Independently collects the facts related to an issue, performs analysis and effectively prepares and communicates concise summaries on moderately complex matters

Background Experience:
  • Bachelor's degree or equivalent experience.
  • 1-3 years’ experience in a regulatory compliance or internal audit position, preferably in healthcare, insurance or financial services or relevant work experience in a business area.
  • Medicaid Managed Care preferred.
  • Possessing Project Management skills is a plus
  • Ability to conduct and manage on-site and virtual audits across multiple cross functional areas.
  • Document understanding of business processes
  • Understand and apply audit standards and methodologies
  • Excellent communication skills (i.e., written and verbal)
  • Proficient in PowerPoint, Excel, and Word
  • Flexible working both autonomously and collaboratively with colleagues and constituents

Clinical Licensure:

Potential Telework Position:

Percent of Travel Required:
10 - 25%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.


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