Internal Controls Analyst

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

Job Summary:

The Internal Controls/ Operational Financial Analyst's role is to work with the VP Finance to strengthen the internal controls of the organization as it relates to core process flows. The Analyst will focus on claim and provider systems dissecting data and working with operational and finance teams as needed to address needed maintenance and workflow changes. The Analyst will also assess vendor SOC reports, working with operational and financial teams, to design processes to meet the requirements of complementary controls. Dashboards will be created to measure progress for all specified areas. The Analyst will closely interact and collaborate with the Plan's Provider, Claim Applications and other teams to create and refine workflows. The Analyst should have an audit background and advanced data mining skills.

Our Investment in You:

* Full-time remote work

* Competitive salaries

* Excellent benefits

Key Functions/Responsibilities:

• Utilizes audit background relating to knowledge general auditing standards, Sarbanes Oxley and/ or Model Audit Rule to assess how to approach a workflow review.
• Works with VP Finance with goal to move towards a control based external audit versus a substantive audit.
• Interacts with various departments within the organization to assist and modify existing workflows to ensure success in eliminating issues that drive exceptions. Specific department interaction would include Applications, Quality, Enrollment, Claims, Provider Maintenance, Business Intelligence Departments as well as Finance and Actuarial.
• Participates in workgroup sessions, applies business experience and analytical skills to assist in creating controls around critical Plan processes and workflows. Define recommendations and improve processes in collaboration with operational teams.
• Develops operational dashboards to monitor improvement or gaps that arise on a monthly basis.
• Regular and reliable attendance is an essential function of the position.
• Responsible for ad hoc analytics as necessary.

Qualifications:

Education:

• CPA current progress towards certification preferred. Bachelor's degree in Accounting or related discipline preferred.

Experience:

• 2-3 plus years of public accounting or internal audit experience is preferred.
• Insurance experience preferred.

Competencies, Skills, and Attributes:

• Team orientation.
• Working knowledge of MS tools, including MS Office products (Access, Project, Visio, Excel), SQL.
• Must be able to analyze current business processes, define new ways of doing business and document clear recommendation for change.
• Excellent analytical and creative problem-solving skills.
• Excellent written and oral communication skills.
• Excellent listening and interpersonal skills.
• Logical and efficient.
• Keen attention to detail.
• Ability to conduct research into systems issues and products as required.
• Ability to communicate ideas in both technical and user-friendly language.
• Highly self motivated and directed.
• Ability to effectively prioritize and execute tasks in a high-pressure environment.
• Experience working in a team-oriented, collaborative environment

Working Conditions and Physical Effort:

• Ability to work OT during peak periods.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees