Top 64 Audit manager Jobs in Mahwah, Nj

Claims Manager, Audit & Complaints
MetroPlusHealth —New York, NY
- $100,000 - $120,000 a year
- Hybrid work
- 5 years
- Research
- Master's degree
Quick Apply
Audit & Assurance Manager - Public Accounting
Magone & Company, P.C. —Parsippany-Troy Hills, NJ
- $120,000 - $140,000 a year
- Full-time
- Hybrid work
- Management
- CPA
- 5 years
- Paid holidays
- Health insurance
Quick Apply
5d
Quality Audit Manager - Rail and Transit
Parsons —Newark, NJ
- $125,100 - $225,200 a year
- Engineering
- Mentoring
- Senior level
- Wellness program
- Paid holidays
5d
Assurance Manager
KRS CPAs, LLC —Paramus, NJ
- $130,000 - $150,000 a year
- Full-time
- Hybrid work
- 7 years
- Microsoft Outlook
- CPA
- AD&D insurance
- Disability insurance
Quick Apply
Financial Operations Audit Manager
Brown & Brown —Roseland, NJ
- $100,000 - $110,000 a year
- Full-time
- Management
- Mid-level
- Analysis skills
- Employee stock purchase plan
- Paid holidays
Internal Audit Manager
Andersen —New York, NY
- $133,800 - $179,600 a year
- Full-time
- CPA
- Office
- Finance
- Paid holidays
- Health insurance
Audit Manager
Dentsu —New York, NY
- $113,000 - $182,000 a year
- Email
- Hybrid work
- Spanish
- 7 years
- CPA
Senior Vice President / Senior Audit Manager - Markets
Lloyds Banking Group —New York, NY
- $170,000 - $200,000 a year
- Office
- Mentoring
- Senior level
- Health savings account
- Disability insurance
Director of Audit Compliance
BRC - Bowery Residents' Committee, Inc. —Manhattan, NY
- $125,000 a year
- Full-time
- Hybrid work
- CPA
- Office
- Analysis skills
- 403(b) matching
- Paid holidays
Financial Services Audit Manager
WithumSmith+Brown —Whippany, NJ
- $110,000 - $190,000 a year
- Full-time
- Hybrid work
- CPA
- 5 years
- Office
Quick Apply
9d
Senior Audit Project Manager - Credit Risk
U.S. Bank National Association —New York, NY
- $133,365 - $156,900 a year
- Full-time
- 5 years
- Office
- Bachelor's degree
- Paid holidays
- Disability insurance
10d
Audit Manager - Public Sector/National Office
Crowe —Livingston, NJ
- $81,000 - $192,000 a year
- Full-time
- Hybrid work
- Management
- CPA
- Research
Quick Apply
Manager, Audit & Tax Marketing
WithumSmith+Brown —Saddle Brook, NJ
- $75,000 - $95,000 a year
- Full-time
- Hybrid work
- 7 years
- Marketing
- Analysis skills
Quick Apply
4d
Senior Audit Project Manager - Capital Markets
U.S. Bank National Association —New York, NY
- $132,260 - $155,600 a year
- Full-time
- CPA
- Office
- 8 years
- Paid holidays
- Disability insurance
External Audit & Assurance Manager
Magone & Company, P.C. —Parsippany-Troy Hills, NJ
- $120,000 - $130,000 a year
- Full-time
- Hybrid work
- Management
- CPA
- 5 years
- Health insurance
- Paid time off
Quick Apply
Audit Manager - Commercial Services
Crowe —Livingston, NJ
- $91,400 - $186,900 a year
- Full-time
- CPA
- Office
- 3 years
Quick Apply
Healthcare Audit Supervisor
WithumSmith+Brown —Whippany, NJ
- $100,000 - $165,000 a year
- Full-time
- Hybrid work
- CPA
- 3 years
- Bachelor's degree
Quick Apply
9d
Audit Manager - Not-for-Profit
PKF O'Connor Davies —New York, NY
- $100,000 - $135,000 a year
- Hybrid work
- 7 years
- CPA
- Office
- Profit sharing
- Health savings account
Quick Apply
Audit Manager I (US)
TD Bank —New York, NY
- $75,020 - $125,180 a year
- Full-time
- 5 years
- Computer literacy
- Mid-level
- Health insurance
- Paid time off
5d
Financial Services Audit Supervisor
WithumSmith+Brown —Whippany, NJ
- $85,000 - $175,000 a year
- Full-time
- Hybrid work
- CPA
- Office
- 3 years
Quick Apply
9d

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Claims Manager, Audit & Complaints

MetroPlusHealth -
New York, NY

Quick Apply

Job Details

$100,000 - $120,000 a year

Qualifications

Medicare
Bachelor's degree
Health insurance knowledge
Medicare regulations
Data-driven problem-solving
Medicaid regulations
Medicaid
Healthcare reimbursement methods
Stakeholder relationship building
Stakeholder management

Full Job Description

Position Overview

Reporting to the Director of Claims Quality, the Claims Manager, Audit & Complaints will oversee operational excellence and regulatory compliance by collaborating with cross-departmental teams to ensure that claims-related
regulatory audits and complaints are thoroughly researched and addressed in a timely manner.

Scope of Role & Responsibilities

Working under the direction of and in collaboration with the Director of Claims Quality, the Claims Manager, Audit & Complaints will:

Act as a liaison for external audits conducted by DOH, CMS, and other regulatory entities related to claims operations
Coordinate audit preparation, assist with documentation collection, internal reviews, SME engagement, and timely submission of materials
Review audit findings and prepare an Executive Summary for Claims Leadership which identifies compliance gaps and deficiencies.
Collaborate with Claims Leadership, Compliance, and upstream operational teams to develop corrective action plans
Monitor and manage corrective action plan implementation, ensuring milestone dates are met
After correction action plans are implemented, periodically audit workflows and processes to ensure ongoing compliance and adherence
Review Claims teams’ complaint triage findings, supporting documents and responses prior to submission to the team managing the complaint to ensure clarity, accuracy, and alignment with regulatory expectations

Working in collaboration with the Regulatory Complaints and the Complaints & Grievance teams gather statistics of complaints related to claims adjudication errors or outcomes, track and trend. The Claims
Manager, Audit & Complaints will:

Identify trends, root causes, and systemic issues impacting accurate claims adjudication and claims quality. Collaborate with Claims leadership to identify systems fixes and configuration
corrections needed. Ensure CPI and or CRF tickets are submitted timely; monitor tickets to ensure timely implementation.
Drive continuous improvement initiatives by translating findings into scalable process and product enhancements
Partner cross-functionally to identify and suggest workflow changes to improve outcomes and quality results.

Required Education, Training & Professional Experience

Bachelor’s degree from an accredited college or university in an appropriate discipline required.
Master’s degree in business, healthcare or public administration preferred.
Minimum 5-7 years experience in a health plan environment, with strong experience in claims operations, compliance, audit, or product management.
Strong knowledge of claims lifecycle, adjudication processes, and reimbursement methodologies
Experience with Medicaid and Medicare products, particularly within New York State
Demonstrated ability to identify operational issues and implement effective, scalable solutions

Professional Competencies

Ability to work cross-functionally and influence without direct authority
Excellent analytical, problem solving, and data interpretation skills
Deep understanding of claims operations and regulatory requirements
Process improvement and operational excellence mindset
Excellent written and verbal communication skills
Ability to manage multiple priorities in a fast-paced, evolving environment
Highly collaborative with strong stakeholder engagement and decision-making skills
Demonstrated sound judgment balancing compliance, operational, and business needs
Commitment to MetroPlusHealth’s Mission, Vision, and Values

#LI-Hybrid

#MHP50

Quick Apply

Refine Your Search

audit manager jobs in mahwah, nj

Claims Manager, Audit & Complaints

Audit & Assurance Manager - Public Accounting

Quality Audit Manager - Rail and Transit

Assurance Manager

Financial Operations Audit Manager

Internal Audit Manager

Audit Manager

Senior Vice President / Senior Audit Manager - Markets

Director of Audit Compliance

Financial Services Audit Manager

Senior Audit Project Manager - Credit Risk

Audit Manager - Public Sector/National Office

Manager, Audit & Tax Marketing

Senior Audit Project Manager - Capital Markets

External Audit & Assurance Manager

Audit Manager - Commercial Services

Healthcare Audit Supervisor

Audit Manager - Not-for-Profit

Audit Manager I (US)

Financial Services Audit Supervisor

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