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Zelis Audit Program Manager in United States

The Audit Program Manager will join the Zelis Compliance Legal Team to oversee audits of various functional areas, including evaluating the effectiveness of risk management practices and internal controls. Analyzes audit results, prepares presentations of findings, and develops recommendations meant to reduce risk and increase protection of organizational assets. Coordinates with external auditors as needed. Leads and directs the work of other employees.

Location and Workplace Flexibility: We have offices in Atlanta GA, Boston MA, Morristown NJ, Plano TX, St. Louis MO, St. Petersburg FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work locations are based on the needs of the position and determined by the Leadership team. In-office work and activities, if applicable, vary based on the work and team objectives in accordance with Company policies.

Responsibilities:

  • Oversees strategic projects with significant scope and impact, which requires sound decision-making, initiative, and intuitive thinking.

  • Leads and develops audit systems involving regulatory, contractual, and internal policy requirements.

  • Monitor and test processes and control environments, report results, and evaluate the organization’s compliance with regulations.

  • Leads comprehensive internal and external compliance audits across the organization.

  • Possess strong project management skills with the ability to manage projects against deadlines.

  • Maintain a professional demeanor and confidentiality in sensitive situations.

  • Recognized as a collaborative business partner with various departments throughout the organization.

  • Leads and directs the work of other employees.

Skills:

  • Strong ability to lead and manage teams effectively.

  • Skilled in embracing and managing complex situations.

  • Expertise in developing and maintaining regulatory and contractual compliance standards.

  • Proficient in organization, project management, and strategic planning.

  • Familiar with process improvement methodologies.

  • Demonstrated ability to meet aggressive time frames with a high level of accountability.

  • High degree of professional ethics and integrity.

  • Sound judgment and ability to analyze situations and information.

  • Excellent verbal communication and documentation skills.

  • Meticulous attention to detail.

  • Deep understanding of regulatory frameworks.

  • Strong project management skills, capable of managing projects against deadlines.

  • Maintain a professional demeanor and confidentiality in sensitive situations.

  • Recognized as a collaborative business partner with various departments throughout the organization.

  • Resourceful, pro-active team player with strong follow-through abilities.

Experiences/Background:

  • BA or BS in Business Management, or similar field

  • 3+ years People Leader experience

  • 5+ years in a role involving audit and project management experience.

  • At least 5 years experience in the healthcare industry and/or compliance with a level of understanding and knowledge of industry practices.

  • Experience working with Centers for Medicare and Medicaid Services

  • Willingness to travel up to 20%.

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity, Inclusion, and Belonging At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

Accessibility Support

We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.

As the leading healthcare payments company, we price, pay and explain care for payers, providers, and healthcare consumers. Zelis was founded on a belief there is a better way to determine the cost of a healthcare claim, manage payment-related data, and make the payment because more affordable and transparent care is good for all of us. We partner with over 700 payers, 1.5 million providers, and millions of members -- enabling the healthcare industry to pay for care, with care.Zelis brings adaptive technology, a deeply ingrained service culture, and an integrated pre-payment through payments platform to manage the complete payment process.

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