Audit Services Manager
Location:
Cincinnati , Ohio
Posted:
October 22, 2017
Reference:
695575BR
Position Summary:
Omnicare,Inc. is a wholly owned subsidiary of CVS Health Corporation. www.cvshealth.com

What We Do

Directly,and through our subsidiaries, Omnicare provides a broad array of pharmacy-related services to long term care facilities and to other customers in the health care environment. While senior care has long been an Omnicare specialty, we also serve other targeted populations.

The Manager Audit Services Pricing is responsible for management of pricing analyses for Omnicare National and Regional accounts.This person is also responsible to manage approximately 8 or employees.

Your Essential Duties &Responsibilities:
  • Perform management review of pricing disputes between Company and facilities
  • Identify discrepancies between the contract and pricing formularies utilized in the billing and dispensing systems
  • Perform management review of third party consultant’s pricing analysis performed on behalf of facilities
  • Identify discrepancies between contractual formularies and third party re-priced amounts
  • Management review of analyzed billing data on a transaction level utilizing a combination of Access and Excel
  • Investigate drug information obtained from Oasis, DX and Omniview for completeness and accuracy of prices, quantities and national drug code based on information from First Data Bank
  • Verify appropriateness of AWP, MAC, WAC,FUL,DIR, SWP prices
  • Determine trends in pricing calculated incorrectly
  • Build summary reports for submission to upper management

Your Management Responsibilities:
  • Management review of analyst’s pricing data and summary reports at the completion of each project
  • Provide leadership, training and mentoring to staff regarding policies and procedures
  • Conduct performance evaluations, discipline employees, hire, terminate and submit pay changes for staff following Human Resources policy and procedures
  • Participate in operations meetings with customers and other committee meetings as needed
  • Perform other projects as directed by senior management
  • Keep senior management advised of concerns and compliance issues


Required Qualifications:

  • A minimum of 3 years of long term care billing or pricing experience


Preferred Qualifications:

  • Familiar with Medicare D reimbursement and facility billing

  • 3-5 years experience with long term care facilities

  • Working knowledge of Omniview, Webfocus, and other operating systems

  • Knowledge of pharmacy policies and procedures

  • Excellent collaboration skills and ability to influence others

  • Ability to build credible relationships with customers and business partners

  • Advanced verbal and written communication skills

  • Strong decision-making and organization skills, ability to build and execute action plans

  • Excellent time management skills including planning and ability to set, maintain, and meet strict deadlines

  • Proficiency with Windows 2010, MS Excel, MS Access, and MS Power Point; ability to learn and apply job related healthcare and other software


Education:

  • Bachelor’s degree or equivalent work experience


Business Overview:
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking AA EEO CVS Health

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/

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