Position Summary: Client Audit Advisor - FA/TF (Formulary Administration/Transition Fill) position is a client / auditor facing position that is responsible for coordinating, managing, tracking and assisting with multiple complex audits and support for Medicare D as assigned, specifically the program/validation audits around FA/TF (Formulary Administration/Transition Fill). Skills must include an ability to obtain client and peer confidence by the demonstration of regulatory expertise as well as knowing how to review claim level questions. In this position you will work closely with various government auditors, our clients, 3rd party consultants, client account teams, benefits, formulary administration teams, legal / compliance colleagues and trade areas to ensure the completion of client/government requested audits with consistency while creating minimal disruption to the business. The advisor will be expected to be client knowledgeable and effective on their feet in mitigating the impact of service issues. This contributor will be responsible for the timely tracking, reporting and satisfactory resolution of exceptions identified during the audit process. Skills must include abilities to analytically identify, track and encourage business owners in process enhancement opportunities to reduce risks, as well as researching claim specific questions.
The successful Advisor will posses the following skills:
- Strong Project Management skills that include the ability to adapt and deal effectively in dynamic, possibly unpredictable, environments while efficiently managing multiple projects from initiation through to completion. A working contributor responsible for each project’s success.
- Ability to interact effectively with Government Auditors, Consultants and Clients while under pressure during a live audit.
- Excellent verbal and written communications skills.
- Excellent analytical and strong critical thinking ability.
- Team building skills that effectively influence and engage others in issue resolution.
Position will require some travel. Notice for such travel may be short and unpredictable. The duration of the various travel engagement may last approximately one full week.
Position can be located at any of the CVS Health Corporate Office locations nationwide or remotely!
Required Qualifications:- Minimum of 6 years of related professional work experience- Prior Project Management experience managing multiple projects simultaneouslyPreferred Qualifications: - Audit experience and PBM experience preferred
- RxClaim adjudication system experience strongly preferred
- Past Pharmacy Benefit Management project management experience is strongly desired
- Medicare regulatory experience is strongly preferred
- Strong Microsoft Office, Excel and Access skills preferred
- CPA, CIA or MBA preferred Education: BS/BA required or equivalent years of related professional work experience in combination with years of education in lieu of a degree. 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 EEO AA CVS Health
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
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/