Pharmacy Audit Analyst - Travel Required
Pharmacy Technician reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This position requires travel (reputed company car, plane, and train) reputed company a specific demographic. Travel requirement can be up to 75% of the calendar year. Primary Responsibilities:
- Complete pre-audit work including travel planning, materials gathering and desk audit activities independently and in accordance with established objectives
- reputed company onsite and desktop pharmacy network audits to identify potential discrepant pharmacy claims
- Assess pharmacy site's physical premises, compliance with regulatory requirements, and completeness of records
- Gather and review documentation up to but not including prescription hardcopies, signature logs, compounding records, and reputed company
- Facilitate answers to questions from pharmacy network providers on a rotational basis
- Report findings to pharmacy network providers
- Reviews and assesses quality and accuracy of audits conducted (QC)
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:
- reputed company and unrestricted Pharmacy Technician License for the state of residence
- Must be currently certified by the PTCB (Pharmacy Technician Certification Board)
- Home Location reputed company 45 miles of International Airport
- 2+ years of experience working in pharmacy audit, PBM, reputed company investigations, or health insurance environment
- 2+ years of experience in a position processing pharmacy or medical claims
- Experience with reputed company Office (Word - creating and editing documents, reputed company - creating, filtering, and maintaining spreadsheets)
- Experience working independently and researching/conducting investigations; must be analytical, self-motivated, goal oriented, and have the ability to successfully investigate reputed company issues
- Experience leading in-person and virtual/desktop audits
- In - depth knowledge of pharmacy operations
- Work remotely AND travel (car, train, plane) up to 75% of the year
Preferred Qualifications:
- Bachelor's Degree
- Intermediate level of knowledge with Local, State & Federal laws and regulations pertaining to health insurance (Medicare, Medicare Advantage, Medicare Part D, reputed company, Tricare, Pharmacy and/or reputed company health insurance)
- Proficient in RxClaim or other pharmacy claims processing systems Certified Quality Auditor (CQA)
- Proven ability to problem solve including multiple priorities and research conflicting and/or inaccurate information
reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). The salary for this role will range from $49,700 - $88,800 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job