Health Plan Auditor I

MO-SSM Health Mission HillWorker Type:RegularJob Highlights:Join a team where your work matters, every moment, every patient, every community. At SSM Health, you'll be empowered to drive meaningful impact through collaboration, innovation, and service excellence.As a Corporate Responsibility Operational Auditor, you'll play a vital role in advancing organizational integrity, operational excellence, and regulatory compliance across our health system. In this position, you'll evaluate processes, identify risks, assess internal controls, and provide actionable recommendations that strengthen operations and support our mission. Partnering with leaders across the organization, you'll conduct operational audits, analyze complex workflows, monitor compliance with policies and regulations, and help drive continuous improvement initiatives. This is an exciting opportunity for a detail-oriented professional who is passionate about problem-solving, mitigating risk, and helping ensure the highest standards of accountability and performance.Work schedule is Monday through Friday, 7:30 a.m. Understanding of audit processes. Ability to review medical records for accuracy. Evaluates and strengthens internal controls across clinical and operational workflows within Epic systems, with a growing focus on AI-driven tools and automation. Ensures that emerging technologies are implemented safely, compliant, and effectively while maintaining the integrity, security, and reliability of healthcare data and processes. Provides leadership in process improvement and collaborative strategies with others as well as compliant approaches to complex situations.Initiates development and maintenance of compliance program, including compliance awareness education, implementation and maintenance of compliance policies and procedures, and monitoring of policy adherence and enforcement.Conducts risk-based audits of Epic workflows, including clinical, revenue cycle, and operational modules.Evaluates the design and effectiveness of internal controls related to system configurations, user access, data integrity, and workflow automation.Reviews change management processes for Epic enhancements, automation scripts, and AI integrations.Has basic working knowledge of AI and automated testing processes and quality assurance tools.Documents audit findings, prepares reports, and communicates recommendations to leadership.Frequent keyboard use/data entry.REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS NoneDepartment:8821000033 Corp ResponsibilityWork Shift:Day Shift (United States of America)Scheduled Weekly Hours:SSM Health provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, gender, pregnancy, sexual orientation, gender identity, national origin, age, disability, protected veteran status, genetic information, or any other characteristic protected by applicable federal, state, or local law. Job SummaryJob number: R200846Profession: Administrative & Business Professionals