Broadway Ventures
Healthcare
RemoteLeadAuditor—IDREntityAudit(CMS)
“Remote Lead Auditor — IDR Entity Audit (CMS) at Broadway Ventures. Skills: Performance audits, Program audits, Enrollment data audit, Financial information audit, Payments audit, Fraud examination, Public accounting, Government Auditing Standards (Yellow Book), Federal regulatory frameworks, Healthcare audit, Data integrity, Program integrity, Healthcare compliance, Fraud investigation, Sampling plans. Deliver the Independent Dispute Resolution (IDR) Entity Audit for the Centers for Medicare. Su”
What You'll Achieve.
Drive operational success, sustainability, and growth.
Industry & Context.
Ability to obtain and maintain any required CMS security and privacy clearances, Availability and commitment to serve in the Key Personnel role for the full period of a signed letter of commitment will be required at proposal submission for any candidate not already employed by the prime contractor or a proposed subcontractor.
What They're Looking For.
Must Have
Minimum of seven (7) years of relevant work experience managing performance audits or programs involving enrollment data, as well as the audit of financial information and payments., Current CFE (Certified Fraud Examiner) and/or CPA (Certified Public Accountant) credential — mandatory., Demonstrated experience reviewing the work of junior auditors and leading multi-member audit teams., Working knowledge of GAAP, Government Auditing Standards (Yellow Book), and Federal regulatory frameworks applicable to healthcare audits., Ability to obtain and maintain any required CMS security and privacy clearances and to complete CMS-required training.
Nice to Have
Bachelor’s degree in accounting, finance, healthcare administration, or a related advanced degree preferred., Experience managing data and program integrity-related projects or programs., Prior healthcare audit, compliance, or program integrity experience with CMS, HHS, other Federal or State agencies, payers, providers, facilities, or arbitration/dispute resolution programs., Familiarity with the Federal IDR process, certified IDR entity operations, and the interplay between Federal requirements and specified State laws or All-Payer Model Agreements., Additional credentials such as CIA (Certified Internal Auditor), CISA, CHC (Certified in Healthcare Compliance), or AHFI (Accredited Health Care Fraud Investigator)., Experience designing statistically representative sampling plans for audits of variable-volume case populations.
What You'll Do.
Deliver the Independent Dispute Resolution (IDR) Entity Audit for the Centers for Medicare, Support calculation of financial impact (e.
, collected but unremitted administrative fees) where applicable., Safeguard sensitive healthcare information and ensure audit execution complies with the No Surprises Act, 45 CFR 149.
510, and all contract security and privacy requirements., Reviewing the work of junior auditors, Leading multi-member audit teams, Author and review audit findings, workpapers, recommendations, and corrective action narratives suitable for publication on the CMS No Surprises Act website.
How You'll Work.
Team & Collaboration
Demonstrated experience reviewing the work of junior auditors and leading multi-member audit teams.
Communication Scope
Written communication skills, including the ability to author and review audit findings, workpapers, recommendations, and corrective action narratives suitable for publication on the CMS No Surprises Act website.
Process & Methodology
Managing performance audits or programs, Managing data and program integrity-related projects or programs
Applying for this Remote Lead Auditor — IDR Entity Audit (CMS) role?
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