Director, Audit Operations

Overview

Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Manager on our Payment Accuracy team.

The Director of Audit Operations is responsible for providing strategic direction, leadership, and management oversight for one or more audit function(s) within the organization. This role entails developing and implementing audit plans for assigned accounts to maximize valid claim identification and overpayment recoveries, meet contractual commitments, and deliver customer satisfaction consistent with established policies, procedures, and best

practices to ensure compliance with regulatory requirements and organizational objectives.

This will be accomplished through effective audit operations management, quality and service assurance, and effective people management and development. The Director leads a team of managers and/or team leads toaccomplish identified goals and strategic results for each calendar year.

Responsibilities

Strategic Planning:

• Hire, develop, coach, lead, and retain top-tier talent, with a focus on building and improving a team and culture that can assist in employing best-in-class practices to support and drive high levels of internal and external customer satisfaction.
• Consistent with people management practices and company values. Provides managerial leadership and directs the selection, supervision, evaluation, and development of employees. Sets objectives and conducts performance reviews for direct reports and oversees the remaining evaluations of indirect team members.
• Follow established processes for training and career progression to enable revenue growth and employee development and engagement. Promotes & participates in knowledge-sharing activities such as best practices, benchmarking, and IT tools enhancement. Ensures that all levels of employees are properly trained on policies, procedures, and best practices and that proper training, education, and required certifications are maintained as required.
• Proactively plan for succession and growth; ensures no gap in productivity and customer service.
• Develop and execute a strategic audit plan aligned with the organization's goals and objectives.
• Collaborate with senior management to ensure alignment of audit priorities with business strategies.

Audit Management:

• Lead and provide guidance, mentorship, and support to ensure the effective performance of both individual contributors and people leaders to navigate budgeting and outline goals for each calendar year.
• Oversee the planning, execution, and reporting of internal audits, including financial, operational, and compliance audits.
• Ensure audits are conducted in accordance with established standards, policies, and procedures.
• Review audit information, findings, and recommendations to ensure accuracy, completeness, and relevance.
• Review progress against established metrics and direct activities as needed to ensure the achievement of business goals and customer expectations. Ensures effective coordination with Engineering and other support functions to achieve audit goals. Demonstrates awareness and sensitivity to the needs of the client, the needs of the audit team, and the profitability of the audit engagement.
• Create, maintain, and monitor quality standards for teams to adhere to fulfill contractual requirements and client satisfaction. Quality is inclusive of the quality of results as well as delivery of whitepapers, adhering to service letter agreements (SLA’s), etc.

Communication:

• Communicate audit findings, recommendations, and corrective actions to senior management and relevant stakeholders.
• Prepare and present audit reports and presentations to executive leadership, audit committees, and other governance bodies.
• Collaborate with stakeholders to address audit findings and implement remediation plans.
• Effectively manages customer problems and conflict, including direct communication with customers to achieve mutually accepted resolution. Assists and removes barriers as needed to identify opportunities for process improvements. Serves as a top escalation point to resolve any customer issues that are roadblocks to customer satisfaction. Partner on the implementation of all appropriate actions