Blue Shield Of California

AI Auditor, Senior

Blue Shield Of California$120K — $150K *
Business Services
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in relevant fields or equivalent experience
  • Minimum 5 years in internal audit, IT audit, or related functions
  • Experience with AI, machine learning, and advanced analytics
  • CISA or equivalent certification required
  • Understanding of AI misuse scenarios and risk assessment
  • Familiar with internal audit methodology and investigative documentation
  • Strong skills in SQL, Python, or similar analytical tools

Responsibilities

  • Support audits focused on identifying non-compliant AI activity
  • Perform analysis of AI system user behavior and logs
  • Assist with investigations of AI-related fraud and misuse
  • Review technical documentation and control evidence for risks
  • Analyze data for anomalous behavior and high-risk activities
  • Document audit procedures and findings in accordance with standards
  • Contribute to AI fraud detection methodologies and improvement initiatives

Benefits

  • Hybrid work model with in-office collaboration two days a week
  • Opportunity to work in a leading health insurance company
  • Engage in innovative projects involving AI technology
  • Exposure to a dynamic team focusing on current fraud and compliance trends
  • Work in a regulated industry with strong emphasis on ethical practices
Full Job Description
Job Description

Your 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, 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. Experience with fraud, compliance and investigations is preferred. The AI Internal Audit Consultant will help 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.

Responsibilities

Your Work

In this role, you will:
  • Support 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 high-risk user activity
  • 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


Qualifications

Your 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 5 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

Hybrid

This 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.

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.

About Blue Shield Of California

Blue Shield of California is a not-for-profit health plan provider that has been providing Californians with access to high-quality healthcare for over 80 years. The company offers a range of health insurance products and services to individuals, families, and employers. Blue Shield of California is committed to improving the health and wellbeing of its members and the communities it serves. The company is also committed to sustainability and has implemented a number of initiatives to reduce its environmental impact.
Learn more about Blue Shield Of California
Size
7,000 employees
Industry
Founded
1981

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