director internal audit in chicago il resume joel lamm
DESCRIPTION
Joel Lamm is an CPA with extensive management experience in internal audit, compliance and fraud control seeking related management position.TRANSCRIPT
JOEL A LAMM CPA Highland Park IL 60035 lammjoelgmailcom Cell 847-275-5355
SUMMARY CPA with extensive management experience in internal audit compliance and fraud control seeking related management position Exceptional leader strong communicator excellent verbal written and interpersonal skills Interact comfortably with all levels of management and staff Highly organized analytical with sound professional judgment Creative and proactive Employers include NorthShore University HealthSystem UnitedHealthcare Blue Cross and Blue Shield of Illinois CNA Insurance and the Wisconsin Insurance Department
EXPERIENCE
NORTHSHORE UNIVERSITY HEALTHSYSTEM Evanston IL Jan 2006 ndash Sept 2013
(Formerly Evanston Northwestern Healthcare) NorthShore is an academic health system affiliated with the University of Chicago It is comprised of Evanston Glenbrook Highland Park and Skokie Hospitals as well as the NorthShore Medical Group Research Institute Foundation and Home Health Services Approximately 10000 employees and 1000 licensed beds
Director Internal Audit Lead staff of four senior auditors and manage all financial operational and compliance audits Responsible for numerous supervisory functions including hiring and performance appraisals Perform special projects and internal investigations
Developproduce quarterly results packets for Audit Committee (AC) which are consistently commended by AC for quality and comprehensiveness
Approve audit programs lead openingclosing meetings conduct weekly status meetings to ensure that audit procedures are effective and projects are completed timely
Perform detailed workpaper reviews ensuring findings are substantive and defensible
Thoroughly review and edit all audit reports resulting in consistently high-quality deliverables
Keep Internal Audit Management and Auditee Management teams informed about status and key issues throughout audits
Work with AVP Internal Audit amp Corporate Compliance on annual risk assessment and development of annual audit plan
Maintain and update corporate compliance policies and procedures (PampP) Serve as entity-wide database administrator for Compliance 360 PampP database
Key audits include Controlled Substances Clinical Trials Research Time amp Effort Medicare Cost Reporting Retail Pharmacies Medical Group Cash Controls Home Health Services Vendor Rebates Payroll Supply Chain Business Continuity Annual Expense Reimbursements and Procard CON (construction) Capital Expenditures Foundation Anti-Kickback amp Stark HIPAA (Privacy HITECH BAAs) Sanctioned Providers Payment Card Industry (PCI) compliance Physician Privileging and Credentialing and Perioperative Services
RESOURCES GLOBAL PROFESSIONALS (RGP) Chicago IL Mar 2005 ndash Dec 2005
RGP is an international professional services firm that provides experienced consultants for project-based engagements Practice areas include Internal Audit Compliance Accounting and Finance and Information Management Consultant Conducted Sarbanes-Oxley (SOX) compliance engagements for Fortune 500 clients including Caremark Hewitt Associates and Waste Management Inc
Interviewed process owners and developed detailed process maps of operations
Performed complex risk-control assessments using the COSO model
JOEL A LAMM CPA Page 2 of 3
Designed comprehensive audit programs to test the effectiveness of existing internal controls
Performed testing and remediation of internal controls over such processes as drug manufacturer rebates billing-to-collections business process outsourcing deferred revenue and deferred compensation
Worked effectively with client management teams to efficiently manage SOX 404 compliance projects
UNITEDHEALTHCARE (UHC) Chicago IL Feb 2003 ndash Dec 2004
UHC is part of UnitedHealth Group a Fortune 100 company ranked 4
th best performing public US corporation by
Business Week UHC provides access to health care through network based offerings National Director Fraud Control Led the team responsible for oversight of outsourced fraud control vendor functions The vendor employed 120 FTEs who conducted fraud investigations adjudicated claims from suspect providers and pursued recoveries on behalf of UHC
Developed financial amp operational performance metrics providing a disciplined approach to managing results
Established a vendor audit program ensuring periodic verification of vendor-reported results
Exceeded annual targets for fraud savings and recoveries by $2M
Led fraud-control process improvement project including the roll-out to Sr Mgmt teams at 28 health plans resulting in an award for operational excellence
Conducted quarterly meetings with health plansrsquo leadership increasing participation in the fraud control effort
Developed ldquoZoomerangrdquo customer satisfaction surveys that evidenced strong stakeholder satisfaction
BLUECROSS BLUESHIELD OF ILLINOIS (BCBSIL) Chicago IL Sept 1998 ndash Jan 2003
1998-2003 BCBSIL is the largest health insurer in Illinois and a division of Health Care Service Corporation The company offers HMO PPO POS and indemnity products Senior Manager National Fraud Investigations (2000-2003) Managed one supervisor four investigators and two clerical workers in the Special Investigations Unit (SIU) Assigned work hired staff evaluated performance led special projects Managed the SIUrsquos relationships with key national accounts
Worked with staff intra-departmental management and attorneys to facilitate provider reviews
Directed recoveries of overpayments
Supervised prepayment reviews
Realigned resources during department reorganization
Repaired relationship with a key account by establishing a dedicated unit amp customizing controls Internal Controls Consultant (1999-2000) Planned and supervised special projects for Internal Audit Identified control weaknesses recommended corrective actions wrote project reports and presented findings
Served as department lead on HIPAA compliance project meeting target dates for all deliverables
Conducted entity-wide presentations on HIPAA regulations and internal controls
Supervised Y2K Quality Assurance teams completing all projects in advance of target dates
Led investment audit team performing tests for external auditors assuring that financials were fairly stated Senior Internal Auditor (1998-1999) Conducted and supervised internal audits of health and life insurance operations Reviewed internal controls wrote audit reports presented findings to management and evaluated the performance of assisting auditors Operations reviewed included premiums claims enrollment HMO capitation purchasing and expense processing
Conducted SAS 70 reviews with Ernst amp Young staff demonstrating quick-study ability in new areas
Wrote detailed audit plans and designed tests that resulted in thorough reviews of internal controls
JOEL A LAMM CPA Page 3 of 3
Made cost-effective recommendations to strengthen controls and obtained management buy-in
Received an outstanding performance review and was promoted to Internal Controls Consultant
CNA INSURANCE COMPANIES Chicago IL Jan 1996 ndash Jul 1998
CNA is a multi-line insurer and the largest commercial insurance group in the US As of year-end 1997 CNA Financial had assets of $63 billion and annual revenue of $18 billion Account ExecutiveUnderwriter- Affinity Markets (1998) Performed financial underwriting of group medical coverages Prepared renewal pricing packages and served as company liaison to third-party administrators (TPAs)
Developed renewal packages using analytical skills to balance premiums with benefits offerings
Negotiated premiums and benefits adjustments with TPAs while maintaining strong partnerships
Identified and terminated unprofitable business relationships safeguarding company assets
Responded to complaints from insurance depts while maintaining excellent rapport with regulators Internal Auditor Life amp Health Operations - Internal Audit Division (1996-1997) Performed financial operational and compliance audits of life and health operations Wrote audit programs performed fieldwork supervised assistants reviewed work papers and wrote audit reports Operations audited included premiums claims purchasing expense processing facilities and human resources Monitored compliance with audit findings
Identified control weaknesses and recommended policies and procedures to strengthen them
Consistently wrote well-crafted audit reports that were rapidly approved by Quality Control
Worked with external auditors on annual audit receiving written commendation for quality of work
OFFICE OF THE COMMISSIONER OF INSURANCE (OCI) Madison WI Nov 1992 ndash Dec 1995
OCI is the state agency responsible for regulating insurance companies domiciled in Wisconsin The agency monitors financial solvency regulates market conduct grants licenses and imposes sanctions Financial Examiner Performed financial operational and compliance audits of life health and property amp casualty insurers Customized audit programs conducted fieldwork wrote audit reports and presented findings to management Led audit teams and reviewed work papers
Performed desk audits of financial statement identifying and addressing violations of investment statutes
Reviewed premium tax returns identifying and addressing errors in tax computations
Consistently completed audit work on a timely basis and received excellent work paper reviews
Promoted twice during tenure at OCI from Financial Examiner I up to Financial Examiner III
EDUCATION amp CERTIFICATIONS
Certified Public Accountant (CPA)
MBA Program University of Illinois Chicago IL Completed 12 courses
BA Liberal Arts University of Illinois Chicago IL Graduated with academic honors
Completed accounting coursework required for CPA exam Oakton College Des Plaines IL
Six Sigma Champion
Managed Health Professional (Health Insurance Association of America)
ORGANIZATIONAL AFFILIATIONS
Association of Healthcare Internal Auditors
Institute of Internal Auditors
JOEL A LAMM CPA Page 2 of 3
Designed comprehensive audit programs to test the effectiveness of existing internal controls
Performed testing and remediation of internal controls over such processes as drug manufacturer rebates billing-to-collections business process outsourcing deferred revenue and deferred compensation
Worked effectively with client management teams to efficiently manage SOX 404 compliance projects
UNITEDHEALTHCARE (UHC) Chicago IL Feb 2003 ndash Dec 2004
UHC is part of UnitedHealth Group a Fortune 100 company ranked 4
th best performing public US corporation by
Business Week UHC provides access to health care through network based offerings National Director Fraud Control Led the team responsible for oversight of outsourced fraud control vendor functions The vendor employed 120 FTEs who conducted fraud investigations adjudicated claims from suspect providers and pursued recoveries on behalf of UHC
Developed financial amp operational performance metrics providing a disciplined approach to managing results
Established a vendor audit program ensuring periodic verification of vendor-reported results
Exceeded annual targets for fraud savings and recoveries by $2M
Led fraud-control process improvement project including the roll-out to Sr Mgmt teams at 28 health plans resulting in an award for operational excellence
Conducted quarterly meetings with health plansrsquo leadership increasing participation in the fraud control effort
Developed ldquoZoomerangrdquo customer satisfaction surveys that evidenced strong stakeholder satisfaction
BLUECROSS BLUESHIELD OF ILLINOIS (BCBSIL) Chicago IL Sept 1998 ndash Jan 2003
1998-2003 BCBSIL is the largest health insurer in Illinois and a division of Health Care Service Corporation The company offers HMO PPO POS and indemnity products Senior Manager National Fraud Investigations (2000-2003) Managed one supervisor four investigators and two clerical workers in the Special Investigations Unit (SIU) Assigned work hired staff evaluated performance led special projects Managed the SIUrsquos relationships with key national accounts
Worked with staff intra-departmental management and attorneys to facilitate provider reviews
Directed recoveries of overpayments
Supervised prepayment reviews
Realigned resources during department reorganization
Repaired relationship with a key account by establishing a dedicated unit amp customizing controls Internal Controls Consultant (1999-2000) Planned and supervised special projects for Internal Audit Identified control weaknesses recommended corrective actions wrote project reports and presented findings
Served as department lead on HIPAA compliance project meeting target dates for all deliverables
Conducted entity-wide presentations on HIPAA regulations and internal controls
Supervised Y2K Quality Assurance teams completing all projects in advance of target dates
Led investment audit team performing tests for external auditors assuring that financials were fairly stated Senior Internal Auditor (1998-1999) Conducted and supervised internal audits of health and life insurance operations Reviewed internal controls wrote audit reports presented findings to management and evaluated the performance of assisting auditors Operations reviewed included premiums claims enrollment HMO capitation purchasing and expense processing
Conducted SAS 70 reviews with Ernst amp Young staff demonstrating quick-study ability in new areas
Wrote detailed audit plans and designed tests that resulted in thorough reviews of internal controls
JOEL A LAMM CPA Page 3 of 3
Made cost-effective recommendations to strengthen controls and obtained management buy-in
Received an outstanding performance review and was promoted to Internal Controls Consultant
CNA INSURANCE COMPANIES Chicago IL Jan 1996 ndash Jul 1998
CNA is a multi-line insurer and the largest commercial insurance group in the US As of year-end 1997 CNA Financial had assets of $63 billion and annual revenue of $18 billion Account ExecutiveUnderwriter- Affinity Markets (1998) Performed financial underwriting of group medical coverages Prepared renewal pricing packages and served as company liaison to third-party administrators (TPAs)
Developed renewal packages using analytical skills to balance premiums with benefits offerings
Negotiated premiums and benefits adjustments with TPAs while maintaining strong partnerships
Identified and terminated unprofitable business relationships safeguarding company assets
Responded to complaints from insurance depts while maintaining excellent rapport with regulators Internal Auditor Life amp Health Operations - Internal Audit Division (1996-1997) Performed financial operational and compliance audits of life and health operations Wrote audit programs performed fieldwork supervised assistants reviewed work papers and wrote audit reports Operations audited included premiums claims purchasing expense processing facilities and human resources Monitored compliance with audit findings
Identified control weaknesses and recommended policies and procedures to strengthen them
Consistently wrote well-crafted audit reports that were rapidly approved by Quality Control
Worked with external auditors on annual audit receiving written commendation for quality of work
OFFICE OF THE COMMISSIONER OF INSURANCE (OCI) Madison WI Nov 1992 ndash Dec 1995
OCI is the state agency responsible for regulating insurance companies domiciled in Wisconsin The agency monitors financial solvency regulates market conduct grants licenses and imposes sanctions Financial Examiner Performed financial operational and compliance audits of life health and property amp casualty insurers Customized audit programs conducted fieldwork wrote audit reports and presented findings to management Led audit teams and reviewed work papers
Performed desk audits of financial statement identifying and addressing violations of investment statutes
Reviewed premium tax returns identifying and addressing errors in tax computations
Consistently completed audit work on a timely basis and received excellent work paper reviews
Promoted twice during tenure at OCI from Financial Examiner I up to Financial Examiner III
EDUCATION amp CERTIFICATIONS
Certified Public Accountant (CPA)
MBA Program University of Illinois Chicago IL Completed 12 courses
BA Liberal Arts University of Illinois Chicago IL Graduated with academic honors
Completed accounting coursework required for CPA exam Oakton College Des Plaines IL
Six Sigma Champion
Managed Health Professional (Health Insurance Association of America)
ORGANIZATIONAL AFFILIATIONS
Association of Healthcare Internal Auditors
Institute of Internal Auditors
JOEL A LAMM CPA Page 3 of 3
Made cost-effective recommendations to strengthen controls and obtained management buy-in
Received an outstanding performance review and was promoted to Internal Controls Consultant
CNA INSURANCE COMPANIES Chicago IL Jan 1996 ndash Jul 1998
CNA is a multi-line insurer and the largest commercial insurance group in the US As of year-end 1997 CNA Financial had assets of $63 billion and annual revenue of $18 billion Account ExecutiveUnderwriter- Affinity Markets (1998) Performed financial underwriting of group medical coverages Prepared renewal pricing packages and served as company liaison to third-party administrators (TPAs)
Developed renewal packages using analytical skills to balance premiums with benefits offerings
Negotiated premiums and benefits adjustments with TPAs while maintaining strong partnerships
Identified and terminated unprofitable business relationships safeguarding company assets
Responded to complaints from insurance depts while maintaining excellent rapport with regulators Internal Auditor Life amp Health Operations - Internal Audit Division (1996-1997) Performed financial operational and compliance audits of life and health operations Wrote audit programs performed fieldwork supervised assistants reviewed work papers and wrote audit reports Operations audited included premiums claims purchasing expense processing facilities and human resources Monitored compliance with audit findings
Identified control weaknesses and recommended policies and procedures to strengthen them
Consistently wrote well-crafted audit reports that were rapidly approved by Quality Control
Worked with external auditors on annual audit receiving written commendation for quality of work
OFFICE OF THE COMMISSIONER OF INSURANCE (OCI) Madison WI Nov 1992 ndash Dec 1995
OCI is the state agency responsible for regulating insurance companies domiciled in Wisconsin The agency monitors financial solvency regulates market conduct grants licenses and imposes sanctions Financial Examiner Performed financial operational and compliance audits of life health and property amp casualty insurers Customized audit programs conducted fieldwork wrote audit reports and presented findings to management Led audit teams and reviewed work papers
Performed desk audits of financial statement identifying and addressing violations of investment statutes
Reviewed premium tax returns identifying and addressing errors in tax computations
Consistently completed audit work on a timely basis and received excellent work paper reviews
Promoted twice during tenure at OCI from Financial Examiner I up to Financial Examiner III
EDUCATION amp CERTIFICATIONS
Certified Public Accountant (CPA)
MBA Program University of Illinois Chicago IL Completed 12 courses
BA Liberal Arts University of Illinois Chicago IL Graduated with academic honors
Completed accounting coursework required for CPA exam Oakton College Des Plaines IL
Six Sigma Champion
Managed Health Professional (Health Insurance Association of America)
ORGANIZATIONAL AFFILIATIONS
Association of Healthcare Internal Auditors
Institute of Internal Auditors