Ready to help us transform healthcare? Bring your true colors to blue. What we need The Regulatory and Compliance Audit team plays a vital role in safeguarding organizational integrity, ensuring sound governance, and verifying the effectiveness of operational and financial controls across Blue Cross Blue Shield of Massachusetts. We are seeking a Senior Audit Specialist to lead and support Model Audit Rule (MAR) evaluations, regulatory readiness reviews, and risk-based operational audits. In this role, you will evaluate key business and IT processes, identify emerging operational and compliance risks, and partner with business leaders to build control consciousness. You will serve as an objective advisor, translating complex audit findings into actionable, value-added recommendations that drive business improvement. This position offers significant visibility into enterprise operations and plays an essential part in supporting the company's financial reporting and compliance commitments. This role is eligible for our Flex worker persona in our Boston or Hingham office . Your Day to Day Execute MAR and Control Audits: Plan, conduct, and support Model Audit Rule (MAR) reviews, operational audits, and related IT control testing in accordance with established audit standards, company policies, and governmental regulations to assess control design and operating effectiveness. Evaluate Core Business Operations: Perform risk-based control evaluations across critical operational and financial areas affecting financial reporting, including Claims Operations, Enrollment, Premiums, Provider Enrollment & Pricing, Accounting, and Information Technology. Audit Reporting & Risk Communication: Synthesize audit findings, prepare high-quality workpapers and audit reports, and articulate control deficiencies and value-added recommendations to Internal Audit leadership and business process owners. Issue Remediation & Advisory: Conduct ongoing follow-up with business unit management to track, validate, and ensure timely resolution of audit findings, while assisting leadership with regulatory and operational readiness assessments. Project Management & Continuous Improvement: Manage multiple concurrent audit projects with tight deliverables, report progress to project leaders, and identify opportunities to enhance audit methodologies, data analytics capabilities, and team efficiencies. . We’re Looking for Analytical & Critical Thinking: Strong analytical, investigative, and problem-solving skills to evaluate complex processes, identify root causes, and propose practical, risk-mitigating solutions. Internal Controls Acumen: Thorough working knowledge of internal control frameworks (e.g., COSO, MAR, SOX), audit testing methodologies, and financial and operational risk evaluation. Communication & Influencing: Excellent verbal and written communication skills with demonstrated ability to draft clear, concise audit reports and cultivate positive, collaborative relationships across all levels of the organization. Organization & Time Management: Proven ability to work independently on low-to-medium complexity assignments and collaboratively within project teams while managing competing priorities and tight deadlines. Technical Aptitude: Proficiency with Microsoft Office tools (Excel, Word, PowerPoint, Visio, Access). Familiarity with audit software (Optro) and data visualization/analytics tools (Tableau, Power BI, SQL, or SAS) is strongly preferred. What You Bring Education: Bachelor’s degree in Accounting, Finance, Business Administration, or a related discipline (Master’s or graduate degree is an asset). Experience: 2–4 years of audit experience in public accounting, internal audit, or risk advisory; experience in healthcare or managed care is preferred but not required. Certifications: Certified Internal Auditor (CIA), Certified Public Accountant (CPA), or active pursuit of a professional certification is strongly preferred. Operational Knowledge: General understanding of business operations, health plan administration, financial reporting workflows, and information technology general controls (ITGCs). What You’ll Gain Enterprise Exposure & Impact: Broad visibility into cross-functional healthcare operations, leadership decision-making, and regulatory frameworks, positioning you as a trusted internal control consultant. Professional Development: Continuous opportunities to expand your audit repertoire across financial, operational, and IT domains, with active support for professional credentials (CIA, CPA, CISA). Flexibility & Balance: Flexible persona-based work options (E-Worker, Mobile, and Resident) designed to support work-life integration. Total Rewards: Access to comprehensive healthcare coverage, wellness programs, tuition reimbursement, retirement benefits, and a culture centered on community wellness and diversity, equity, and inclusion. #LI-HYRBID Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above Location Boston Time Type Full time Salary Range: $89,460.00 - $109,340.00 The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability. This job is also eligible for variable pay. We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. WHY Blue Cross Blue Shield of MA? We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL. As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page. Voted as the highest in member satisfaction among Massachusetts commercial health plans by JD Power, Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 75 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to effectively serving our 2.8 million members, and consistently offering security, stability, and peace of mind to both our members and associates. Our Commitment to You We are committed to investing in your development and providing the necessary resources to enable your success. We are dedicated to creating a refreshing and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path. We take pride in our diverse, community-centric, wellness-focused culture and believe every member of our team deserves to enjoy a positive work-life balance. Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law. Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.

Sr. Audit Specialist.

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