Job Description
Job Description
Would you like to be part of a dynamic Client Audit team within our PBM commercial group at Fortune 5 CVS Health?!! As a Client Audit Advisor, you will assist primarily with day to day activities and responsibilities for the claims accuracy and client audits. You will be in a client facing project management role that is responsible for completing contractually required claims, performance guarantees and coordinating, managing and assisting with commercial client audits as assigned.
You will work closely with various third party consultants and auditors, client account teams, legal and trade areas to ensure the completion of guarantees and client requested audits with consistency and minimal disruption to the business. You will be responsible for the timely and satisfactory resolution of exceptions identified during the review and audit processes. You will also be expected to identify process enhancement opportunities to reduce or eliminate risk of future performance guarantee and audit exceptions.
Required Qualifications
5 or more years of experience in project management, audit or PBM insurance/healthcare experience
Preferred Qualifications
Compliance experience
Risk management experience
PBM experience
Bachelors degree preferred.
CPA, CIA or MBA preferred.
Education
Bachelors degree required.
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
Would you like to be part of a dynamic Client Audit team within our PBM commercial group at Fortune 5 CVS Health?!! As a Client Audit Advisor, you will assist primarily with day to day activities and responsibilities for the claims accuracy and client audits. You will be in a client facing project management role that is responsible for completing contractually required claims, performance guarantees and coordinating, managing and assisting with commercial client audits as assigned.
You will work closely with various third party consultants and auditors, client account teams, legal and trade areas to ensure the completion of guarantees and client requested audits with consistency and minimal disruption to the business. You will be responsible for the timely and satisfactory resolution of exceptions identified during the review and audit processes. You will also be expected to identify process enhancement opportunities to reduce or eliminate risk of future performance guarantee and audit exceptions.
Required Qualifications
5 or more years of experience in project management, audit or PBM insurance/healthcare experience
Preferred Qualifications
Compliance experience
Risk management experience
PBM experience
Bachelors degree preferred.
CPA, CIA or MBA preferred.
Education
Bachelors degree required.
Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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