Audit Manager

Nature of Work
Department of Human Services (DOHS) / Bureau for Medical Services (BMS) / Kanawha County – Under limited supervision, this position performs expert-level accounting, auditing, and reporting functions within the Bureau’s Office of Program Integrity’s Financial Audit Program.

Key responsibilities include:

• Serving as the liaison with WV state staff during non-Bureau state audits of the Bureau for Medical Services Medicaid program integrity.
• Managing the creation and implementation of corrective action plans as needed.
• Assisting federal, state, and local law enforcement agencies in specialized fraud investigations by referring suspected fraud to the Office of the WV Attorney General Medicaid Fraud Control Unit.
• Conducting unannounced on-site audits of provider records and facilities.
• Performing audits of Medicaid services and processes, provider fraud investigations, and special compliance reviews, including internal control evaluations and recommendations.
• Investigating high-value and complex audits of claims, encounters, capitation, revenue codes, and administrative payments made by the Bureau.
• Analyzing complex administrative and technical issues to prevent fraud, waste, and abuse by applying forensic accounting principles and recommending improvements.
• Evaluating and approving the selection of information for findings reports and provider letters.
• Writing comprehensive review programs, auditing claim payments and financial records, and developing sampling techniques for evaluation.
• Preparing reports of audit findings, recommendations, and conclusions, and assisting in explaining them to agency leadership and partners.
• Developing, implementing, and maintaining audit schedules.
• Performing highly specialized and complex analysis, auditing, and reporting functions, requiring extensive knowledge of Bureau programs, policies, data, and related state and federal regulations.
• Ensuring compliance with reporting rules and deadlines through independent judgment in interpreting policies, rules, and regulations.
• Acting as the agency contact to maintain, track, and manage requests from external auditors.
• Evaluating operational procedures and recommending improvements to enhance efficiency and effectiveness.
• Performing other related duties as required.

Minimum Qualifications

Training: Bachelor's degree from an accredited college or university with at least 24 semester hours in accounting.

AND

Experience: Four (4) years of full-time or equivalent part-time paid experience in professional accounting, statutory accounting, auditing work, forensic accounting, public accounting, investigative and/or forensic auditing, certified fraud examining, or other directly related accounting.

OR

Substitutions: (1) Master's degree in accounting may substitute for two (2) years of the required experience. (2) Certification or registration as a Public Accountant in West Virginia may be substituted for the training and two (2) years of the required experience.

Preference will be given to applicants holding a Certified Fraud Examiner (CFE), Certified Forensic Accountant (CFA), Certified Valuation Analyst (CVA), or applicants who have completed a graduate certificate program in forensic accounting and fraud investigation.

Other Information

Substitution: An additional one (1) year of experience in accounting, auditing, bookkeeping, and/or finance may substitute for the required accounting semester hours at the rate of one (1) year of experience for every thirty semester hours.

Job Type: Full-time

Pay: $43,357.00 - $75,789.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Application Question(s):

• Are you authorized to work in the United States without the need for sponsorship now or in the future?

Ability to Commute:

• Charleston, WV 25301 (Preferred)

Ability to Relocate:

• Charleston, WV 25301: Relocate before starting work (Preferred)

Work Location: In person

Salary : $43,357 - $75,789