Internal Audit Manager – Health Insurance

Zing Health • Remote, IL

2d • $140,000 - $145,000

About The Position

The Internal Audit Manager is responsible for leading and executing risk-based internal audit activities across health insurance operations. This role plays a critical part in evaluating governance, risk management, and internal control effectiveness, including compliance with regulatory requirements, the Model Audit Rule (MAR) and Own Risk and Solvency Assessment (ORSA). Experience in Medicare Advantage is strongly preferred due to regulatory complexity and heightened oversight.

Requirements

• Bachelor’s degree in Accounting, Finance, Business Administration, or a related field.
• Seven or more years of internal audit, external audit, or risk management experience within the health insurance industry.
• Demonstrated experience with ORSA and Model Audit Rule (MAR) requirements.
• Strong knowledge of internal control frameworks and risk management principles.
• Strong analytical, written, and verbal communication skills.

Nice To Haves

• Medicare Advantage experience.
• Professional certification such as CPA, CIA, CISA, or similar.
• Experience interacting with regulators, external auditors, or state insurance departments.
• Prior experience leading or mentoring audit staff.

Responsibilities

• Plan, lead, and execute complex internal audit engagements across health insurance operations, including claims, provider relations, utilization management, finance, compliance and FDR functions.
• Evaluate the adequacy and effectiveness of internal controls, operational processes, and risk management practices in accordance with professional auditing standards.
• Plan, lead and execute audits and testing related to the Model Audit Rule (MAR).
• Lead and support development of the Own Risk and Solvency Assessment (ORSA) annual process and reporting, regulatory examinations, and external audits.
• Prepare ORSA regulatory reports.
• Assess compliance with federal and state regulations applicable to health insurers, including CMS requirements for Medicare Advantage programs.
• Develop audit scopes, risk assessments, and work programs using a risk-based audit approach.
• Prepare audit reports and present findings and remediation plans to senior management.
• Monitor corrective action plans and validate remediation of audit findings.
• Provide advisory support on risk mitigation, control design, and process improvements.
• Manage, coach, and mentor audit staff or co-sourced resources as applicable.

Benefits

• A competitive salary based on the market
• Medical, Dental, and Vision
• Employer-Paid Life Insurance
• Paid Maternal Leave
• Paid Paternal Leave
• 401(K) match up to 4%
• Paid-Time-Off
• Employee Assistance Programs
• Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager