Job DescriptionYour Role The Internal Audit Services team provides independent, objective assurance and advisory services to help Blue Shield of California manage risk, strengthen internal controls, and improve business processes. The AI Internal Audit Consultant will support audit, compliance, fraud detection, and investigative activities focused on the use and misuse of artificial intelligence systems. In this role, you will assist with AI-focused audits looking at usage, systems, and algorithms with a focus on identifying inappropriate, nefarious, fraudulent, and non-compliant activity. In this role you will essentially look for bad actors / activity via AI.
The AI Internal Audit Consultant will lead the effort to evaluate AI activity, system usage, data flows, prompts, outputs, logs, access patterns, process documentation, and control evidence to identify suspicious behavior, potential compliance violations, fraud indicators, or inappropriate use of AI tools.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
ResponsibilitiesYour Work In this role, you will:
- Lead AI-focused audits, advisory reviews, and investigative activities designed to identify inappropriate, suspicious, fraudulent, unauthorized, unethical, or non-compliant AI activity
- Perform testing and analysis of AI system activity, user behavior, prompts, outputs, logs, access patterns, workflow data, and system usage trends to identify indicators of misuse or fraud
- Assist with investigations involving AI-enabled fraud, insider threat, policy violations, unauthorized data use, inappropriate AI activity, suspicious automation, or circumvention of controls
- Review system documentation, AI platform configuration, model documentation, data flows, policies, procedures, control evidence, monitoring reports, and technical artifacts to identify risks and control gaps
- Analyze AI platform data and business process data for anomalous behavior, unusual usage patterns, excessive access, suspicious outputs, unauthorized automation, or highrisk user activity
- Incorporate the schedules, abilities, and know-how from less experienced team members, guiding their effort in performing audits
- Help develop the annual audit plan using a risk-based approach
- Document audit procedures, investigative steps, evidence reviewed, testing results, exceptions, conclusions, and workpapers in accordance with internal audit methodology
- Support interviews, walkthroughs, and fact-gathering activities with business stakeholders, technology teams, data scientists, Compliance, Legal, HR, Privacy, Information Security, and control owners
- Assist in developing clear audit observations and investigative findings that explain risk, root cause, impact, evidence, and practical recommendations
- Conduct data analytics to identify patterns, clusters, outliers, and trends that may indicate nefarious activity, fraud risk, control failure, or non-compliant AI usage
- Research emerging AI misuse and fraud techniques, including prompt manipulation, synthetic content, deepfakes, data leakage, AI-assisted scams, automated abuse, and unauthorized decision support
- Track remediation activities and support follow-up testing to validate whether corrective actions address identified AI misuse, fraud, compliance, or control issues
- Contribute to AI fraud detection playbooks, audit templates, investigative procedures, control libraries, testing scripts, dashboards, and methodology improvements
- Maintain strong professional relationships with stakeholders while preserving internal audit independence, objectivity, confidentiality, and evidence integrity
QualificationsYour Knowledge and Experience - Requires a Bachelor's degree in Accounting, Information Systems, Computer Science, Data Science, Business Administration, Cybersecurity, Criminal Justice, Engineering, or related field, or equivalent experience
- Requires a minimum of 7 years of prior related experience in internal audit, IT audit, technology risk, compliance, fraud detection, investigations, information security, data governance, data analytics, model risk management, or related assurance functions
- Experience with artificial intelligence, machine learning, advanced analytics, automation, AI platforms, AI governance, model risk, or emerging technology controls
- CISA certification required, or equivalent certification such as CFE, CIA, CISSP, CRISC, CISM, CPA, CDPSE, or other relevant audit, risk, privacy, security, fraud, investigations, or technology certification
- Experience with fraud detection, compliance monitoring, investigations, insider threat, cybersecurity, suspicious activity monitoring, intelligence analysis, or forensic-style review preferred
- Working knowledge of internal audit methodology, investigative documentation, risk assessment, control testing, audit evidence, workpaper standards, issue development, and remediation follow-up
- Familiarity with AI misuse scenarios, including unauthorized data disclosure, AI-assisted fraud, synthetic identities, prompt manipulation, automated abuse, inappropriate data use, and circumvention of controls
- Experience performing analytical reviews using SQL, Python, Tableau, Databricks, Excel, Power BI, log analytics, or similar tools preferred
- Knowledge of fraud indicators, investigative techniques, compliance monitoring, insider threat risks, suspicious activity review, and evidence handling preferred
- Ability to communicate technical concepts, suspicious activity patterns, and control issues clearly to audit, business, technology, compliance, and investigations stakeholders
- Strong analytical, problem-solving, organizational, documentation, and professional skepticism skills
- Ability to manage multiple assignments, meet deadlines, handle sensitive information, and work both independently and collaboratively in a team environment
- Experience in health care, health insurance, financial services, technology, or another regulated industry preferred
- Experience with fraud, compliance and investigations is preferred.
HybridThis role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.
Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.
About the TeamAbout Blue Shield of California and the Ascendiun Family of CompaniesAs of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Ascendiun, we believe in a brighter future for healthcare. As the parent to a family of four innovative healthcare companies, we're reimagining what's possible. Ascendiun is guided by the goal of transforming a dysfunctional American health care system into one worthy of our family and friends and sustainably affordable for everyone.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Our Values: - Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, and showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model: We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
- For most teams, this means coming into the office two days per week.
- Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
- For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
Physical Requirements:Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
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