Monica L. Sykes
Internal Audit Profesional
Port Saint Joe,FL
Summary
Results Driven Audit/Compliance Professional
Proven audit professional with integrity, demonstrated leadership ability, and innovative thinking skills. Over 25 years of experience in all areas of audit management; operational, financial, IT, regulatory and compliance, fraud, and corrective action development. Recognized for the ability to increase efficiencies, improve the effectiveness of risk management, provide value added solutions and partner with management. Proficient at driving results, risk assessment, audit programs, managing critical situation performance, and motivating and energizing staff.
Overview
30
30
years of professional experience
4
4
Certificates
Work History
Manager Internal Audit
National Government Solutions, Elevance Health/Anthem
Indianapolis, IN
01.2015 - 12.2022
- Elevance Health (Anthem) is one of the nation’s leading health benefits companies with over 73 million people served by its affiliated companies, including nearly 40 million enrolled in its family of health plans
- Subsidiaries Amerigroup, CareMore, UniCare, Healthlink, and National Government Solutions serve consumers and providers enrolled in Medicaid and Medicare
- Key Contributions: Planned, supervised staff, managed engagement economics, and performed operational, legal, compliance and information technology engagements (ARS Control/912, FISMA, ISO) and business consulting within Commercial, Government Business Divisions, and Medicare Administrative Contractor (MAC) Operations
- Responsible developing and implementing Annual Master Audit Plan and Audit Departments Quality Assessment and Improvement Program
- Directed staff in the development of comprehensive risk assessments, and the development and execution of risk based audit plans /programs.
- Adept at partnering with management to resolve findings and develop meaningful and effective corrective action plans
- Cross-trained existing employees to maximize team agility and performance.
- Onboarded new employees with training and new hire documentation.
- Managed and motivated employees to be productive and engaged in work.
Advanced Senior Internal Auditor
Johns Hopkins Institutions
Baltimore, MD
01.2012 - 01.2015
- Johns Hopkins has been recognized as a leader in patient care, medical research and teaching for over a century. Johns Hopkins Medicine is known for its excellent faculty, nurses and staff specializing in every aspect of medical care
- Johns Hopkins Medicine includes six academic and community hospitals, four suburban health care and surgery centers, more than 30 primary health care outpatient sites, as well as programs for national and international patient activities
- Key Contributions:Planned, supervised staff, managed engagement economics, developed risk matrices, executive reports and performed operational and compliance engagement within the Health System
- Team leader on complex audits including; Pharmacy, 340B, Revenue Cycle/Charge Master, ER, Inpatient, Surgery, Endowments, Professional Practices, Materials Management, and Charity Care resulting in many value added observations
- Developed comprehensive risk assessments, process flows, detailed audit plans and programs and executive reports Supervised staff, reviewed workpapers, and provided training and served as a resource to Hospital Management and peers
- Provided support and audit coordination for external auditors Actively participated in Hospital monthly Directors meetings Developed and presented Audit Department status and quarterly results to Hospital Finance Board of Directors Meetings
- Contributing member of the Physician/ Professional Practices Compliance Committee including communicating and providing educational sessions to address compliance and key issues
Senior Internal Auditor
Amerigroup Corporation
Tampa, Fl
01.2008 - 01.2012
- Fortune 500, Managed Health Care Company focused on serving people who receive healthcare benefits through publicly sponsored programs, including Medicaid, Children’s Health Insurance Program (“CHIP”), Medicaid expansion programs, and Medicare Advantage
- Key Contributions: Planned, supervised staff, managed engagement economics, developed executive reports and performed operational and compliance engagement, covering functional areas as; provider network adequacy, medical economics and finance, NCQA and clinical quality performance standards, case management, care coordination, utilization and concurrent review, appeals and grievances claims processing, health promotion and member outreach and pharmacy resulting in more then one hundred reportable observations Developed presentation materials, facilitated multiple opening conference meetings, status update meetings and closing presentations focused on partnering with management to resolve findings and keep them informed throughout the engagement of potential observations and next steps
- Contributed to the transition of Independent Review Organization (IRO) Audits to Internal Audit developed and led compliance reviews focused marketing reviews focused on marketing member enrollments, disenrollment’s provider relations, quality, and efforts to control health benefits ratios, leading the team review in Nevada in conjunction with the IRO Developed comprehensive risk assessments, process flows, detailed audit plans and programs and executive reports Work with Management to develop and resolve corrective action plans Served as team lead on IIA Quality Assessment obtaining favorable results and having the department recognized for adherence to the IIA Professional Standard
Manager
The Institute Of Internal Auditors
Altamonte Springs, FL
01.2005 - 01.2007
- The Institute of Internal Auditors (IIA) is an international professional association recognized as the internal audit profession’s leader in certification, education, research, and technological guidance
- Key Contributions:
- Managed Department with a staff of four employees responsible for day to day operations, supervision, coordination and performing training and career development
- Staffed and/or participated in performing external quality assessments/peer reviews of multiple client audit departments serving companies of all sizes and industries
- Developed systems for gathering, analyzing, and disseminating best practices knowledge and techniques to the profession
- Functioned as a liaison to IIA team leaders and IIA clients
- Identified and recruited potential team leaders and volunteers to conduct external quality assessments
- Participated in the proposal process by contacting potential clients, overseeing proposal preparation, and contacting clients with questions regarding the proposal
- Participated in the budget preparation process for the entire organization included preparing annual department budgets utilizing both zero based budgeting approach as well as trend analysis
Education
Bachelors - Accounting
Northern Illinois University
Graduate - Health Care Mgmt
University of South Fl
Skills
Information Technology and IT Security Audits/Business Continuity
undefinedCertification
Certified Internal Audit (CIA) Certified Financial Services Auditor (CFSA) Certified Risk Management Assurance (CRMA)
Timeline
Manager Internal Audit
National Government Solutions, Elevance Health/Anthem
01.2015 - 12.2022
Advanced Senior Internal Auditor
Johns Hopkins Institutions
01.2012 - 01.2015
Senior Internal Auditor
Amerigroup Corporation
01.2008 - 01.2012
Manager
The Institute Of Internal Auditors
01.2005 - 01.2007
Certified Internal Audit (CIA) Certified Financial Services Auditor (CFSA) Certified Risk Management Assurance (CRMA)
ISO 20000 / 270001 Lead IT Auditor
CRMA - Certified Risk Management Assurance
CFSA - Certified Financial Services Auditor
Bachelors - Accounting
Northern Illinois University
Graduate - Health Care Mgmt
University of South Fl
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