KOLAWOLE AKINROLABU

• Identify and prioritize providers for audit using prior audit results, network management input, risk indicators, and claim volume.
• Perform desktop reviews by analyzing claims data, billing patterns, medical documentation, itemized bills, and contract terms to define scope and select claims.
• Present irregularities and findings to leadership; propose remediation actions, timelines, and summarize results for executive audiences.
• Monitor remediation adequacy by evaluating action plans, validating corrective actions, maintaining status reporting, and escalating delays/risks.
• Conduct on-site state audits in coordination with OMPP, including provider site visits required for certification and compliance validation.
• Review medical charts, clinical notes, itemized statements, and provider contracts to confirm documentation supports billed services and reimbursement aligns with contract/policy.
• Lead entrance and exit conferences with provider leadership to communicate objectives, preliminary findings, corrective actions, and timelines.
• Validate claim payment amounts in the claims system; document outcomes and produce clear, comprehensive audit reports.
• Request recovery of identified overpayments and track audit outcomes through resolution.
• Identify aberrant billing trends and potential FWA; escalate concerns following established protocols.
• Coach and educate providers on HCBS compliance expectations (state rules, documentation standards, billing requirements, and best practices).
• Contribute to audit policies, procedures, and training materials; participate in cross-functional task forces and committees.

• Perform member Health initial needs and brief chat assessment.
• Monitor and coordinate the services of my clients.
• Collaborate and partner with the providers, internal care team, and community resources to establish an Individual care plan – (ICP)
• Engage clients one-on-one to complete a comprehensive needs assessment quarterly, annually, or as needed.
• Evaluating clients’ progress periodically and adjusting as needed to improve outcomes.
• Provide referral and linkage promptly to suit clients' needs such as home delivery meals, community-based providers, pharmacy teams, and medication-assisted therapy (IHCC)
• Document client interaction, maintain accurate records, and prepare detailed reports on clients, progress, and outcomes for internal and external stakeholders.

• Collaborate with community organizations and government agencies to expand service options and improve accessibility for clients.
• Conduct home visits, facilitate support groups coordinate educational workshops, and enhance their skills for independent living.
• Ensuring that the agency meets its quality improvement, evaluation, and reporting requirements.
• Advocate for clients’ rights and access to services, providing guidance and assistance in navigating the healthcare system and social services.
• Listening to clients’ concerns and providing counseling or intervention as required
• Maintained detailed case notes, ensured compliance with regulations, and participated in team meetings to discuss clients’ progress and strategies for improvement.

• Provide analytical support to program contract staff preparing corporate required reporting of accounts receivable, billed, and unbilled reconciliations.
• Attended and took detailed notes during walkthroughs, documented ITGC and Application Control Workpapers
• Review incoming vendor invoices for accuracy, provide appropriate codes, and monitor payment status.
• Manage all audit issue remediation and validation phases with relevant internal stakeholders and external auditors.
• Financial reporting and information technology risks, processes, and controls.
• Conduct and coordinate a Follow-up on IT audit findings and recommendations to ensure corrective actions have been taken. Ensured compliance with applicable laws, regulations, and contractual obligations; third-party contractors engaged to perform significant services on behalf of the Company
• Conduct the review and test of key information technology general controls (ITGC) such as change management, computer operations, backup, data integrity testing, segregation of duties, access control, audit log, enabled services, remote access control, application-level security, and environmental control around the data centers and for financially related ERP systems (NetSuite, Oracle Financials, SAP)
• Performed periodic review of MAAR (Management Application Access Review) and part of ITGCs and IT application Control’s testing using COSO and COBIT frameworks. This is also the basis for user access re-certification in the AD.

• Participate in the mapping of business processes and influence the quality of documentation related to risk and controls to prevent downstream impact on effective self-assurance activity design.
• Design and implement SOC 2 & ISO27001 security Frameworks with various clients.
• Oversee the implementation of Corrective Action Plans (CAP) with first and second lines of defense and present updates of the findings to the Internal Audit Management and responsible stakeholders respectively.
• Partner with control/process owners and other partners to design Self-Assurance Activities around business controls. Ensure design can withstand scrutiny from external audits and reviews.
• Execute tests of controls to identify exceptions, error rates, and testing conclusions to include effectiveness. Document test results and provide to peer teams who will raise control Issues for remediation.
• Review SIG questionnaires in line with NIST SP 800-53 & ISO 27001 frameworks for vendor assessments.
• Perform quality reviews of risk and control information to ensure adequate information is in place to develop an effective assurance activity around the control and escalate recommendations for quality enhancements when problems are identified.
• Drive maturity updates to the Contact Center Self-Assurance Activity methodology and lifecycle through a mindset of continuous improvement.
• Recommend and drive towards automated solutions whenever possible in design and execution

• Develop and enforce rigorous compliance protocols across IT platforms, focusing on securing sensitive corporate and personal data.
• Lead audits and compliance assessments regarding data security and risk management, setting benchmarks for corporate standards in IT security.
• Create comprehensive risk management frameworks that serve as models for robust data security practices in non-healthcare and healthcare settings alike.
• Performed periodic review of MCA/MAAR (Management of Application Access Review) and part of SOX- Audit.
• Updated Activity Risk Monitoring and Controls (ARMCs) Matrix comprising all Organization’s Controls.
• Conducted IT Infrastructure and Platforms operations audits (e.g., Operating Systems -UNIX, Windows, Databases, Network Devices, Virtual Machine, Performance and Capacity, Collaboration tools etc.)
• Managed all phases of audit issue remediation and validation with relevant internal stakeholders and external auditor.
• Led Business Continuity and Disaster Recovery Audit by evaluating backup and recovery plans.
• Supervised and performed innovative testing of design and operational effectiveness of ITGC to provide reasonable assurance to management.
• Developed detailed work plans, schedules, project estimates, and resource plans for managing audit team annual budget and schedule.
• Engaged in external compliance initiatives including SOX, PCI DSS, and other compliance coordination of auditors interfacing with IT staff, guidance for appropriate remediation actions for findings, communication, and escalation.
• Identified and assign tasks to audit resources and ensured audit deliverables met quality expectations while execution was accomplished within established budgets and schedules.

• Optimize financial processes through the implementation of advanced IT solutions.
• Ensure that financial systems are up-to-date and capable of interfacing seamlessly with broader IT infrastructure, focusing on performance and capacity.
• Performed month end account closing through analyzing and reconciliation of financial statement
• Lead the development and implementation of business continuity plans, focusing on stock taking and financial stability.
• Develop and manage a comprehensive risk management framework integrating IT infrastructure insights into financial risk assessments.

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