POSITION SUMMARYThe Staff Auditor is responsible to identify pharmacy audit risks using analytical skills and audit tools and develop and execute audit plans and scope of procedures determined necessary to address those risks. This position will complete investigational audits in order to correct risks identified and present findings to the Sr Audit Manager. The Staff Auditor may participate in third party audits and work collaboratively with cross functional partners to complete research needed and provide background knowledge needed to interpret audit scope. This position may act as a resource for less experienced team members and work on special projects as needed.ESSENTIAL FUNCTIONS
Utilize current programs and analytical procedures and existing tools, including Access, Excel, etc., to identify financial as well as contract compliance risks for Pharma clients.
Performance of audits includes obtaining, analyzing, and appraising evidentiary data on which to base an informed, objective opinion on the accuracy and legitimacy of data audited.
Participates in all external Third Party Pharma Audits. Will work with Pharma Account Manager to ensure sufficient research is conducted to provide accurate background knowledge necessary to the process of development and/or interpretation of the audit scope. Once audit is completed, will publish internal report on all deficiencies or recommendations made by the sponsor’s representative. Once official report is received, will work with business owners to remediate any and all risks identified and will respond with all action items to sponsor’s representative.
Special projects as assigned and as needed.
Analyzes audit findings to determine validity of any identified discrepancies. Has full responsibility for handling/researching complex issues identified during a Pharma audit. Prepare formal and thorough written reports providing opinions on the findings of the audits performed, client impact, ESI risk, etc. as needed. Submit findings to Audit Manager for review.
Perform efficient and effective investigational audits to produce results consistent with departmental policies and critical corporate goals while meeting or exceeding personal production goals.
QUALIFICATIONS
Bachelor’s degree or equivalent work experience
PBM, healthcare, financial analysis, accounting or auditing experience preferred
Valid driver’s license required
Certified Pharmacy Technician preferred
Proficient in spreadsheet applications, ie: Microsoft Excel, Access, Word
Excellent organizational, interpersonal, and communication skills.
Excellent interpersonal skills and the ability to effectively communicate with all levels of management
Previous experience working with cross functional departments to research and resolve issues using innovative solutions
Demonstrated ability to meet multiple deadlines and manage a dynamic workload
Ability to work a flexible schedule to accommodate project deadlines
Demonstrated adept discretionary judgment in analysis of findings and ability to outline recommendations for specific outcomes
Ability to handle sensitive or confidential information is critical to success of the role
Ability to work with minimum management oversight while performing on-site audits. Ability to work a flexible schedule to accommodate project deadlines.
Travel up to 50% of the time
ABOUT THE DEPARTMENTOur Pharma & Retail Relations team plays a key role in keeping us at the forefront of the health care evolution. Team members oversee partnerships with Express Scripts’ key supplier groups, including brand and generic pharmaceutical manufacturers, retail pharmacies and drug wholesalers. Successfully maintaining these relationships allows our 100 million patients access to the medicine they need at a price they can afford.If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.About Evernorth Health ServicesEvernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.