Your Role

The Employee Fraud Program Internal Auditor, Senior Principal, reporting to the Internal Audit Senior Director, is responsible for establishing, strategizing, implementing and managing the organization's fraud detection and continuous monitoring program.

This role involves establishing a comprehensive and robust fraud control department focused on developing controls, database of types of fraud, and what is considered fraud audit for BSC. Collaborating cross functionally with management to mitigate fraud risks, and work with leaders to prioritize fraud prevention efforts and implement recommendations. Will build a multi-year fraud detection program and will work with IT, IT Internal Audit and across the organization to implement a continuous auditing program to detect fraud.

The role is highly cross functional and will work with Vice Presidents, Senior Directors and Directors across the enterprise. The role will provide coaching on control design, how controls can be tested, educate management on fraud scenarios and red flags, and support the implementation of a stronger control environment. The role will also collaborate with Legal, Cybersecurity, Physical Security, Compliance and Ethics and Enterprise Risk Management.

Your Work

In this role, you will:

• Establish a comprehensive Fraud Control Database spanning all business processes, with associated fraud categories and schemes
• Facilitate Control Self-Assessment workshops for management across the enterprise, to educate employees about fraud controls, fraud risks and prevention methods
• Develop and implement a continuous fraud auditing program to analyze large volumes of data based on fraud schemes on a regular cadence or real time to identify suspicious and/or abnormal behaviors
• Ensure all fraud control owners are maintaining their controls, testing on a regular cadence, and remediating processes or controls, on an as needed basis
• Utilize data analysis tools to identify patterns and discrepancies indicative of fraud
• Prepare detailed reports of the findings and present them to Senior Management
• Create a culture of fraud awareness, continuous improvement and educate management on specific potential fraud schemes and fraud detection and monitoring controls
• Work closely with Legal, Compliance and other departments to ensure effective fraud risk management
• Stay updated with the latest fraud trends and methodologies to enhance detection capabilities

Your Knowledge and Experience

• Bachelor's degree in Finance, Accounting, Criminal Justice, a related field or equivalent experience
• Minimum 10 years of experience in Fraud Detection/Investigation, Auditing or a related field
• Certified Fraud Examiner (CFE) credentials required
• Certified Internal Auditor (CIA) preferred
• Certified Information Systems Auditor (CISA) preferred
• Previous experience in a corporate fraud prevention, detection and monitoring program
• Proficiency in data analysis tools and software
• Strong analytical and problem-solving skills
• Expert knowledge of operations and all forms of fraud, with internal controls solutions to mitigate risk for BSC
• Excellent verbal and written communication and interpersonal skills
• Ability to work independently and manage multiple projects simultaneously
• High level of integrity and confidentiality

Pay Range: The pay range for this role is $165,990.00 to $248,930.00 for California.

Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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