Job Description

As a Performance Auditor, you will play a crucial role in ensuring the integrity and efficiency of Wellmark’s core business processes. Your responsibilities will include conducting Blue Cross Blue Shield Association validation audits of claims payments, member benefits and enrollment, customer service inquiries, and provider contracts. You will leverage your expertise to analyze and improve financially and operationally significant corporate functions and transactional data, contributing to the overall success and compliance of the organization. As a Performance Auditor II, you will also compile and present reports to operational stakeholders and collaborate closely with business leaders to develop and monitor effective corrective action plans.

Ideal candidates will have a bachelor's degree and prior experience in finance, business, or related fields. To be successful in this role, you will be detail-oriented and have the communication skills to build strong relationships with peers and stakeholders. Coworkers and friends would say you are able to identify issues or inconsistencies easily, with the ability to summarize findings and develop action plans accordingly. You are thorough, deadline-driven, and leave no stone unturned.

Qualifications

_ Performance Auditor I_

_ Required:_

• Bachelor’s degree or equivalent work experience
• Prior experience in a Finance/ Accounting/ Banking/ Business related field
• Ability to identify issues or inconsistencies using strong business knowledge and perspectives
• Strong attention to detail, with the ability to complete tasks accurately and completely
• Strong communication skills, both verbal and written

_ Performance Auditor II_

_ Required:_

• Bachelor’s degree in Accounting or related field, or equivalent work experience
• Minimum 1 year of internal or external Audit experience
• Proven analytical skills, with the ability to analyze data and make recommendations
• Strong communication skills, both verbal and written
• Demonstrated interpersonal skills with the ability to build and develop collaborative relationships of trust
• Strong attention to detail with the ability to complete tasks accurately and completely
• Ability to be flexible and adaptable while recommending changes to workflow to improve processes while guiding others through it

_ Preferred:_

• Bachelor's degree

Additional Information

a. Performs mandatory Blue Cross Blue Shield Association program audits using statistical sampling methodologies, including coverage of core business transactions such as claims, membership & enrollment, customer service, provider data, and plan to plan interaction.

b. Performs operational performance guarantees audits using statistical sampling methodologies in accordance with contractual requirements.

c. Performs audit projects as assigned, including issue identification and coordination of corrective action plans in accordance with regulatory and Blue Cross Blue Shield Association (BCBSA) guidance.

d. Compiles and reviews populations of transactional data against established parameters for accuracy and completeness. Develops and documents samples to be audited in accordance with audit requirements.

e. Assists in the preparation of reports summarizing audit findings, and participates in presentations to operational stakeholders. Supports collaboration with business unit leaders to develop and monitor corrective action plans for identified audit issues.

f. Compiles and maintains audit documentation in appropriate files, databases, and systems to support audit work performed, conclusions/issues identified, and recommendations/action plans.

g. Maintains and continually improves understanding of Wellmark’s business and business environment including compliance with laws and regulations, new products and services offered by Wellmark, organizational structure, corporate policies, and Wellmark’s strategic direction.

h. Assists with external audits conducted on behalf of large group accounts, including document preparation, analysis, and research for development of audit responses.

i. Abides by the Global Internal Audit Standards when supporting the Internal Audit team. Other duties as assigned.

j. Other duties as assigned.

_ _ An Equal Opportunity Employer__

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us atcareers@wellmark.com

Please inform us if you meet the definition of a "Covered DoD official".