Claims Quality Audit Director jobs in South Carolina

Claims Quality Audit Director directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Being a Claims Quality Audit Director creates claims audit policies and procedures. May recommend changes in claims processing procedures. Additionally, Claims Quality Audit Director typically Requires a bachelor's degree. Typically reports to top management. The Claims Quality Audit Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Quality Audit Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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Director of Internal Audit
  • South Carolina Education Lottery
  • Columbia, SC FULL_TIME
  • WHO WE ARE

    The South Carolina Education Lottery (“SCEL”) was formed in 2001, pursuant to the South Carolina Education Lottery Act (the “Act”). Operations commenced in early 2002, and since then SCEL has transferred over $8.4 billion to the State Treasurer to support education in South Carolina.

    SCEL currently has 125 employees that are organized into ten departments: Executive Office, Finance, Human Resources, Information Technology, Legal, Licensing, Marketing, Product Development, Sales, and Security. A majority of SCEL’s employees report out of the Columbia Business Office & Claims Center. However, the field sales staff (approximately 45 employees) report out of their home office locations throughout the state, as their primary objective is to serve SCEL Retailers.  

    In Fiscal Year 2023, SCEL reported revenues of $2.4 billion. All sales are completed through a network of Retailers, the majority of which are convenience stores. Retailers sell SCEL lottery products and receive a commission of 7%. SCEL offers   two types of products: Instant Tickets (“Scratch-Off” Games) and Terminal Game Tickets (“Draw Games”), which are numbers driven and are purchased by players through a Retailer terminal. Draw Games include Pick3 and Pick4 (plus Fireball), Palmetto Cash 5, MegaMillions and Powerball.

    SCEL maintains contracts with two international lottery product vendors. Services provided by the vendors include (1) the development and printing of all of SCEL’s Instant Tickets and our Player Rewards application/website and (2) the outsourced operation of the sales and processing system used to execute all sales, along with other back office functions pertaining to the maintenance of retailer information. SCEL’s business and sales model allows it to operate very efficiently and in Fiscal Year 2023, general and administrative expenses were 0.43% of revenues.

    SCEL is overseen by a nine-member Board of Commissioners; three are appointed by the Governor, three are appointed by the Speaker of the House, and three are appointed by the President of the Senate. The current Board Chairman is Sam Litchfield, III. Dr. Edward Keith serves as the Chairman of the Board’s Audit Committee. The Executive Director is Dolly Garfield, who has been employed with SCEL for 8 years, and previously served as its General Counsel. 

    GENERAL REQUIREMENTS

    The Act requires that SCEL employ an Internal Auditor who reports to the Board. The Director of Internal Audit is the sole member of the internal audit function and reports directly to the SCEL Board of Commissioners through its Audit Committee, and administratively to the SCEL Executive Director. This reporting structure promotes independence and complies with internal auditing standards. The Board and Executive Management believe this is an appropriate structure due to the organization’s size, and because retail sales and significant processing and business systems are outsourced to highly experienced and reputable vendors. Additionally, SCEL has significant internal and professional resources who oversee daily operations, and who contribute significantly to an overall stable and dependable control environment.  

    Accordingly, the general requirements of the Director of Internal Audit necessitate that the candidate have excellent communication skills at all levels. The candidate must be able to communicate effectively with the Board, as to provide advice and insights to the Audit Committee, which will enhance the Committee’s ability to perform its oversight duties. The candidate must also work effectively with senior management and demonstrate a high level of business and professional knowledge, which will benefit SCEL and its operations. Moreover, the candidate must be a self-starter who can plan, execute and report audits. 

    SPECIFIC REQUIREMENTS

    The Director of Internal Audit performs advanced professional work, providing independent assurance that the SCEL’s risk management, governance, and internal controls are operating effectively. This position is responsible for conducting an annual risk assessment, developing an annual audit plan based on the results, and conducting planned audits. The Director of Internal Audit provides consultation and conducts investigations to assess business risks, accountability, and compliance with federal, state, and local laws. 

    FUNCTIONS & RESPONSIBILITIES

    • Prepares the annual audit plan for approval from the Board of Commissioners, with input from senior management, which includes audit, investigative, and cross-functional activities for the Internal Auditor.
    • Provides the Board of Commissioners with a regular update of internal audit activities, in addition to providing copies of final internal audit reports to the Audit Committee and appropriate SCEL senior management.
    • Ensures work papers are adequately documented and audit evidence is sufficient. Prepares accurate and timely audit reports for the Audit Committee and Board of Commissioners.
    • Communicates with the Audit Committee Chair on a regular basis; communicates the results of audit and consulting projects via written reports and oral presentations to the Audit Committee. Understands the informational needs of executive management and keeps them informed.
    • Confers with management and the Audit Committee to review audit plans, audit results, and recommendations to resolve audit findings.
    • Coordinates any outsourced audit services required by SCEL, particularly periodic service organization compliance audits (SOC), as well as external audits performed by the Legislative Audit Council (LAC). 
    • Provides advice and consultation to SCEL management in carrying out audit recommendations and correcting programmatic and operational weaknesses to reduce the potential for fraud and waste.
    • Models open, clear, and objective communication and builds trust in the internal audit function. Serves as a resource to management in providing special reviews, as requested, or where needs are indicated.
    • Determines and manages budgetary requirements, priorities, and objectives for the internal audit function.
    • Develops a strategic vision to enhance and clarify the framework for how the internal audit function addresses risk within SCEL’s operations.
    • Directs the overall activities of the internal audit function. Establishes and updates internal auditing policies, programs, plans, schedules, and procedures.
    • Operates in a highly confidential manner to ensure effective work results that are mindful of privacy policies and other legal considerations.
    • Completes special projects, tasks, and other duties as assigned or required.

    MINIMUM QUALIFICATIONS

    • A Bachelor’s degree in Accounting, Finance, Business or related field;
    • A minimum of 5-8 years of auditing experience, in internal audit and/or public accounting.
    • Professional designation, such as CPA (Certified Public Accountant), CIA (Certified Internal Auditor), CISA (Certified Information Systems Auditor) or CFE (Certified Fraud Examiner); and
    • Thorough knowledge of professional auditing standards, procedures, techniques, and internal control.

    KNOWLEDGE, SKILLS & ABILITIES

    • Knowledge of internal control systems, professional auditing standards, operational practices, and best practices specific to internal audit; 
    • Knowledge of current software development technologies, trends, and methodologies; 
    • Knowledge of Microsoft Office, flowcharting, and audit management software; 
    • The ability to manage multiple complex audit or investigation projects; 
    • The ability to obtain, prepare, and organize information and data used in connection with audits and other internal audit activities; 
    • The ability to analyze complex financial information; 
    • The ability to understand and evaluate complex processes and internal controls; strong project management skills; 
    • The ability to communicate complex information simply and clearly, both orally and in writing; 
    • A strong ability to develop and use collaborative relationships to facilitate the accomplishment of the internal audit function’s mission, goals, and objectives; 
    • The ability to identify and understand issues, problems, and opportunities; 
    • The ability to compare data from different sources to draw conclusions; 
    • The ability to coordinate and perform multiple tasks/projects simultaneously, balancing priorities and deliverables; and
    • The ability to work independently and within a team environment to accomplish goals.

    COMPENSATION & BENEFITS

    Employment with the South Carolina Education Lottery is at-will, and not covered by the South Carolina State Employee Grievance Procedures Act. SCEL offers a competitive compensation package, which includes participation in State benefits through the Public Employee Benefit Authority (PEBA) such as Health Insurance, Retirement Plans (defined contribution and pension plans available), Deferred Compensation and a generous Leave Program. For more information please visit the following links:

    • PEBA Insurance Summary
    • PEBA Retirement Plans
    • South Carolina Deferred Compensation Program
  • 12 Days Ago

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Quality Director
  • Traylor Bros., Inc.
  • Greenville, SC FULL_TIME
  • Quality Director opportunity with Traylor Industrial Founded in 1985, Traylor Industrial is a reputable, quality-driven, turn-key contractor focused on safety, service, and efficiency. Traylor Industr...
  • 1 Day Ago

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Director Quality
  • MUSC
  • Florence, SC FULL_TIME
  • Job Description SummaryResponsible for ongoing review of medical records to ensure compliance with established nationally recognized quality patient outcomes. This individual must assume a leadership ...
  • 15 Days Ago

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Director Quality
  • Roper St. Francis Healthcare
  • Charleston, SC FULL_TIME
  • Job Summary: Responsible for the strategic leadership of quality and accreditation at Roper Saint Francis Healthcare. This includes performance improvement, clinical quality and operational effectiven...
  • 20 Days Ago

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Director of Quality
  • Integrated Power Services
  • Greenville, SC FULL_TIME
  • Description Who We Are: Integrated Power Services (IPS) is the leading North American solution provider for power management, electro-mechanical and rotating assets. Serving customers across a wide ra...
  • 2 Months Ago

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Director of Quality
  • Integrated Power Services
  • Rock Hill, SC FULL_TIME
  • Description Who We Are: Integrated Power Services (IPS) is the leading North American solution provider for power management, electro-mechanical and rotating assets. Serving customers across a wide ra...
  • 2 Months Ago

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Director of Quality Control
  • RF Hiring Solutions
  • Director of Quality Control Reports To: Chief Executive Officer Summary: Director of Quality Control will ensure that th...
  • 6/1/2024 12:00:00 AM

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Senior Director of Quality Control
  • Ascend Advanced Therapies
  • Alachua, FL
  • Title: Senior Director of Quality Control Reporting to: VP Quality Location: Alachua, Florida, USA (On-site role) The Al...
  • 6/1/2024 12:00:00 AM

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Director of Quality Management
  • Select Specialty Hospital - South Dakota (Sioux Falls)
  • Sioux Falls, SD
  • Overview: Critical Illness Recovery Hospital Director of Quality Management At Select Specialty/Regency Hospitals, a div...
  • 6/1/2024 12:00:00 AM

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Director of Quality Management
  • Select Specialty Hospital - The Villages
  • Oxford, FL
  • Overview: Critical Illness Recovery Hospital Director of Quality Management $10,000 Sign-on Bonus At Select Specialty/Re...
  • 6/1/2024 12:00:00 AM

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Director of Quality Control
  • Partnership Employment
  • New York, NY
  • Our client, a well-known fast casual chain, is looking to hire a Director of Quality Control in their Bronx office. Oppo...
  • 5/31/2024 12:00:00 AM

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Director of Quality Control
  • Kinetics
  • Durham, NC
  • Founded in 1973, Kinetics is a global full-service process and mechanical contractor specializing in the design and inst...
  • 5/31/2024 12:00:00 AM

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Director of Quality Control
  • Kalon Executive Search for Health and Wellness
  • Los Angeles, CA
  • Our client, a health and wellness company are seeking a qualified Director of Quality Control to help build a solid, sta...
  • 5/31/2024 12:00:00 AM

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Director of Quality Control
  • ADAGE INNOVATIONS INC
  • Alexandria, VA
  • Job Description Job Description Benefits/Perks Competitive Compensation Great Work Environment Career Advancement Opport...
  • 5/31/2024 12:00:00 AM

South Carolina (/ˌkærəˈlaɪnə/ (listen)) is a state in the Southeastern United States and the easternmost of the Deep South. It is bordered to the north by North Carolina, to the southeast by the Atlantic Ocean, and to the southwest by Georgia across the Savannah River. South Carolina became the eighth state to ratify the U.S. Constitution on May 23, 1788. South Carolina became the first state to vote in favor of secession from the Union on December 20, 1860. After the American Civil War, it was readmitted into the United States on June 25, 1868. South Carolina is the 40th most extensive and 23...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Audit Director jobs
$143,501 to $205,076

Claims Quality Audit Director in Olympia, WA
Based on our compensation data, the estimated salary potential for Claims Quality Audit Director will increase 16 % over 5 years.
December 23, 2019