Auditor (Medicare Part C)

Senior Auditor

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This position is established as a senior auditor in a division office (Centers for Medicare and Medicaid Audit Division (CMSAD), Office of Audit Services (OAS), Office of the Inspector General (OIG), Health and Human Services (HHS). The senior auditor will provide audit services to CMSAD which conducts and oversees audits of the Medicare and Medicaid programs. The senior auditor in CMSAD serves as a subject matter expert for Medicare, Medicaid, and Children's Health Insurance programs which are extremely large (approximately $1.5 trillion in annual spending) Federal healthcare programs with very complex rules and regulations. The senior auditor assists in directing CMSAD audits that focus on applicable OIG priority outcomes. The senior auditor receives assignments to serve as a member of an audit team and independent work assignments for an audit segment or study project.

The incumbent studies pertinent laws, legislative history, regulations, contracts, and management controls to ascertain the purpose, scope, and objectives of the organization or function; the manner in which the organization or function is conducted and financed; and the nature and extent of management authority and responsibility for the organization or function. Plans and contributes to comprehensive audits for a wide range of health and human services programs, grantees and contractors, and others receiving funds from programs administered by the Department. Develops or modifies auditing methods and techniques to resolve a variety of complex auditing problems. Conducts detailed presurvey analysis, including correlation of findings and conclusions resulting from pre-survey analysis and evaluation to ascertain probable scope and depth of audit and to identify problems. Provides advance notification and develops and disseminates guidelines on probable areas of emphasis, approaches which may be expected, pre-survey readiness actions, development of audit response plan. The senior auditor will provide expert advice and direction for the program content of medical review contracts. The senior auditor will coordinate with the Division Director and regional staff to ensure that medical review is performed when needed. The senior auditor will assist in the monitoring of the contractors' adherence to program requirements and interact, if necessary, report any deficiencies to the Division Director.