Internal Audit Manager
Polaris Pharmacy Services
Internal Audit Manager
At Polaris Pharmacy Services, we're more than a pharmacy — we're a dedicated partner in care, transforming how patients experience long-term, post-acute, correctional, PACE, and specialty pharmacy services. As industry leaders, we're raising the bar for quality and coordination across all sites of care, ensuring every patient receives seamless, compassionate, and expert support.
Founded in 2015, Polaris is proud to be locally and independently owned, with a growing national footprint. Our team thrives in a mission-driven environment where innovation meets purpose, and every role contributes to making a real impact. We offer more than just a job — we provide competitive pay, robust benefits, and genuine opportunities for career advancement.
If you're passionate about shaping the future of pharmacy and making a difference in the lives of those who need it most, we invite you to grow with us.
Key Responsibilities
- Develop and execute an annual risk-based internal audit and monitoring plan in coordination with the Senior Director of Compliance and relevant stakeholders.
- Lead audits, reviews, and monitoring activities across healthcare compliance risk areas, including billing and coding, claims, documentation, privacy, conflicts of interest, vendor oversight, exclusion screening, licensure, credentialing, quality, and other operational compliance domains.
- Evaluate the design and operating effectiveness of internal controls, policies, procedures, and business processes against applicable federal and state healthcare requirements, payer rules, accreditation standards, and company policies.
- Prepare clear, accurate, and timely audit reports that summarize scope, methodology, findings, root causes, risk levels, recommendations, and management action plans.
- Track corrective action plans through completion, validate remediation, and escalate overdue or high-risk items as appropriate.
- Partner with Compliance leadership to maintain audit workpapers, evidence, risk assessments, dashboards, and reporting materials for executive leadership, committees, and regulatory inquiries.
- Support compliance investigations, special reviews, and data analytics projects by gathering records, interviewing stakeholders, testing controls, and documenting findings.
- Identify emerging compliance risks, trends, and control gaps, and recommend practical improvements to policies, training, processes, and systems.
- Coordinate with operational leaders to provide audit education, feedback, and guidance that promotes a culture of accountability, transparency, and continuous improvement.
- Supervise, coach, and develop internal audit staff or project resources, including assigning work, reviewing workpapers, providing feedback, and supporting professional development.
- Maintain current knowledge of healthcare laws, regulations, enforcement trends, OIG guidance, CMS requirements, HIPAA, state requirements, payer expectations, and internal audit standards.
- Perform other compliance, audit, monitoring, and risk management duties as assigned.
Required Qualifications
- Bachelor's degree in accounting, finance, business administration, healthcare administration, health information management, nursing, public health, or a related field.
- Minimum of five years of experience in internal audit, compliance auditing, healthcare compliance, revenue cycle auditing, risk management, public accounting, or a related control function.
- Experience planning and executing audits, documenting workpapers, testing controls, identifying root causes, and presenting findings to management.
- Working knowledge of healthcare regulatory and compliance requirements, such as HIPAA, CMS rules, federal healthcare program requirements, Anti-Kickback Statute, False Claims Act, Stark Law, OIG guidance, payer requirements, and applicable state laws.
- Demonstrated ability to manage multiple audits or projects simultaneously, prioritize risk, meet deadlines, and maintain confidentiality.
- Strong written and verbal communication skills, including the ability to communicate findings clearly to both technical and non-technical audiences.
- Proficiency with Microsoft Office applications and experience using data analysis, audit management, compliance management, or governance/risk/compliance tools.
Preferred Qualifications
- Professional certification such as CIA, CPA, CISA, CHC, CHPC, CHRC, RHIA, RHIT, CCS, CPC, or equivalent healthcare compliance, audit, privacy, or coding credential.
- Experience in a healthcare provider, health system, payer, managed care, pharmacy, behavioral health, home health, hospice, or other regulated healthcare environment.
- Experience with data analytics, claims testing, billing and coding audits, privacy audits, or enterprise risk assessments.
- Prior supervisory or people-management experience.
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