Job Description

Job Description

A Brief Overview

Through coordination with the Chief Financial Officer, the Operational Risk Coordinator will assure that identified areas of operational, business and compliance risk of Avera Health Plans receive audit coverage based upon an analysis of their relative risk. Operations audit coverage will include compliance with internal policies, processes, controls, governmental guidelines and laws as well as assessing reporting accuracy and operational efficiency. The Operational Risk Coordinator will develop and manage reporting to communicate on the operational control environment, control gaps and results of audits.

What you will do

• Develops and executes a comprehensive monitoring and audit program for the evaluation of management processes and controls, regulatory compliance, and operational efficiency of Insurance Division operations activities.
• Establishes and manages the annual audit schedule.
• Recommends improvement of management processes and controls designed to reduce operational risks, promote regulatory compliance, and improve service levels and operational efficiency.
• Reviews data developed during each audit project and ensures that audit reports are factual and fairly presented to management.
• Appraises the adequacy of action taken by management to address Insurance Division Variance Reports and takes such follow-up measures as until significant issues have been satisfactorily resolved.
• Conducts special examinations at the request of management.
• Ability to exercise good judgment, attention to detail with strong analytical skills.
• Possess necessary interpersonal skills to interact with various levels of management.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Job Requirements

Required Education, License/Certification, or Work Experience:

Bachelor's in accounting, finance, business or related field
4-6 years Experience within either the healthcare insurance industry in an audit, accounting or finance related position, or in public accounting.

Expectations and Standards:

Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
Promote Avera’s values of compassion, hospitality, and stewardship.
Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
Maintain confidentiality.
Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Job Tags

Work experience placement,

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