Top 176 Audit manager Jobs in Maplewood, 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 Manager
Distinct —New York, NY
- $130,000 - $170,000 a year
- Full-time
- 6 years
- CPA
- Office
- Health insurance
- Dental insurance
Quick Apply
4d
Audit Manager II (US) - Financial Crimes Audit
TD Bank —New York, NY
- $92,220 - $149,310 a year
- Full-time
- 7 years
- CPA
- Basic math
- Health insurance
- Paid time off
14d
Audit Manager II (US) - Financial Crimes - Regulatory Issue Validation
TD Bank —New York, NY
- $92,220 - $149,310 a year
- Full-time
- 7 years
- Microsoft Excel
- Basic math
- Health insurance
- Paid time off
Audit Manager II (US) - Financial Crimes - Internal Audit Issue Validation
TD Bank —New York, NY
- $92,220 - $149,310 a year
- Full-time
- 7 years
- Basic math
- Office
- Health insurance
- Paid time off
2d
Quality Audit Manager - Rail and Transit
Parsons —Newark, NJ
- $125,100 - $225,200 a year
- Engineering
- Mentoring
- Senior level
- Wellness program
- Paid holidays
Audit Manager
Fiserv —Berkeley Heights, NJ
- $100,000 - $165,600 a year
- Full-time
- 6 years
- CPA
- Office
- Paid parental leave
- Employee stock purchase plan
Manager, Internal Audit
SOLV Energy, LLC —Edison, NJ
- $111,777 - $148,663 a year
- Full-time
- CPA
- Office
- Finance
- Paid holidays
- Disability insurance
Quick Apply
8d
Audit Manager
Marsh —New York, NY
- $100,700 - $201,500 a year
- Full-time
- Hybrid work
- CPA
- Office
- Microsoft Office
- Health insurance
- 401(k)
Audit Manager
Current —Somerset, NJ
- $100,000 - $140,000 a year
- Full-time
- Hybrid work
- Management
- CPA
- 3 years
- Disability insurance
- Health insurance
Audit Manager, Contract Assurance Reviews
Sanofi —Morristown, NJ
- $105,000.00 - $151,666.66 a year
- Contract
- English
- Office
- 3 years
- Health insurance
- Parental leave
Audit Manager
JPMorganChase —Jersey City, NJ
- $137,750 - $200,000 a year
- Full-time
- 7 years
- CPA
- Office
- Health insurance
- Tuition reimbursement
8d
Audit Manager
Dentsu —New York, NY
- $113,000 - $182,000 a year
- Email
- Hybrid work
- Spanish
- 7 years
- CPA
Audit Manager (2 Positions)
OFFICE OF THE COMPTROLLER —Manhattan, NY
- $110,000 - $135,000 a year
- Multiple hires
- 18 years or older
- Computer Science
- 5 years
- Loan forgiveness
Configuration and Quality Audit Manager | Hybrid NY
Healthfirst —New York, NY
- $88,700 - $149,430 a year
- Full-time
- Hybrid work
- 6 years
- Office
- SQL
- Health insurance
- Dental insurance
Audit Manager - Global Servicing
American Express —New York, NY
- $89,250 - $150,250 a year
- Full-time
- Hybrid work
- CPA
- 5 years
- Project management
- Paid parental leave
- Health insurance
Senior Manager, Audit (Hybrid - 3x a week in Secaucus, NJ)
Quest Diagnostics —Secaucus, NJ
- $160,000 - $175,000 a year
- Full-time
- CPA
- Bachelor of Science
- Office
- Employee stock purchase plan
- Disability insurance
Quick Apply
11d
Claims Manager, Audit & Complaints
MetroPlus Health Plan —New York, NY
- $100,000 - $120,000 a year
- Full-time
- Hybrid work
- 5 years
- Research
- Office
Audit Manager
Treliant LLC —New York, NY
- $125,000 - $175,000 a year
- Full-time
- Hybrid work
- CPA
- 5 years
- Research
- Health insurance
- 401(k)
Audit Manager - Commercial Services
Crowe —Livingston, NJ
- $91,400 - $186,900 a year
- Full-time
- CPA
- Office
- 3 years
Quick Apply
1d

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audit manager jobs near maplewood, nj

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 maplewood, nj

Claims Manager, Audit & Complaints

Audit Manager

Audit Manager II (US) - Financial Crimes Audit

Audit Manager II (US) - Financial Crimes - Regulatory Issue Validation

Audit Manager II (US) - Financial Crimes - Internal Audit Issue Validation

Quality Audit Manager - Rail and Transit

Audit Manager

Manager, Internal Audit

Audit Manager

Audit Manager

Audit Manager, Contract Assurance Reviews

Audit Manager

Audit Manager

Audit Manager (2 Positions)

Configuration and Quality Audit Manager | Hybrid NY

Audit Manager - Global Servicing

Senior Manager, Audit (Hybrid - 3x a week in Secaucus, NJ)

Claims Manager, Audit & Complaints

Audit Manager

Audit Manager - Commercial Services

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