Business Audit – Senior Analyst
Company | CVS Health |
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Location | Florida, USA, Illinois, USA |
Salary | $46988 – $112200 |
Type | Full-Time |
Degrees | |
Experience Level | Mid Level, Senior |
Requirements
- 3+ years of professional experience, preferably in a retail pharmacy setting, or in fields of pharmaceutical and/or pharmacy regulatory industry
- Must be able to travel up to 70% of the time. Travel includes flights, overnight stays, local travel, travel on short notice, and other travel deemed necessary by the company.
- Must possess valid and current driver’s license.
- Must possess personal vehicle sufficiently reliable to meet the requirements of the job and is appropriately insured.
- Ability to handle difficult situations
- Pharmacy Technician Licensure
- Certified Pharmacy Technician (PTCB)
Responsibilities
- Conduct claims audits at pharmacies throughout multiple states by reviewing prescription claims billed and educating pharmacies on the findings.
- Analyze claims for fraud, waste, and abuse trends and report findings to the corporate office.
Preferred Qualifications
- Candidate must have excellent time management skills
- Ability to work independently and make decisions with a self-starter mentality
- Ability to plan and appropriately schedule audits in advance
- Ability to plan travel on the company’s site in a cost effective manner
- Knowledge of CVS Health (or other PBM) claims processing
- Knowledge of retail pharmacy operations including reading prescriptions and drug knowledge
- Excellent verbal and written communication skills
- Experience with MS Office, including Excel and Word