Pharmacy - Pharmacy Auditor Coordinator 146-1013 at CommunityCare

Tulsa, Oklahoma, United States -

Full Time

Start Date

Immediate

Expiry Date

30 May, 26

Salary

0.0

Posted On

01 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Auditing, Monitoring, Stakeholder Management, Corrective Action Planning, Follow-up Audits, Root Cause Analysis, Financial Support, Invoice Comparison, Regulatory Requirements, Reporting, Tracking, Mathematical Calculations, Interpersonal Skills, Microsoft Applications

Industry

Insurance

Description

JOB SUMMARY: Responsible for auditing and monitoring company processes. Meets with stakeholders to review corrective action and obtain resolution. Conducts follow-up audits to ensure corrective actions have addressed the root cause to prevent errors from recurring. This position will also provide financial supporting functions to the Director of Pharmacy such as high-alert drug notifications and weekly invoice comparisons. KEY RESPONSIBILITIES: Audit and monitor company processes and business activities. Verifying all documentation and regulatory requirements are met. Meet with process owners and or departments to obtain corrective action plans and obtain resolution. Prepare reports of findings to present to stakeholders. Track status and monitor plans through implementation. Conduct follow-up audits to ensure corrective actions address the root cause and prevent errors from recurring. Track new members on high-cost drugs. Performs other duties as required. QUALIFICATIONS: Ability to perform detailed mathematical calculations and understanding of mathematical concepts and abstract reasoning. Ability to converse and write fluently in English Ability to read with understanding, to reason logically and to use good judgement when interpreting materials or situations. Ability to plan, organize, schedule and follow through on assignments. Excellent interpersonal skills and the ability to work with individuals at all levels of the organization. Successful completion of Heath Care Sanctions background check. Proficient in Microsoft applications. EDUCATION/EXPERIENCE: Bachelor's degree preferred. 1-3 years' experience in auditing. Certified Internal Auditor (CIA) or Certified in Healthcare Compliance (CHC) certification preferred. Experience in managed healthcare preferred. CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin

Responsibilities

The role is responsible for auditing and monitoring company processes, meeting with stakeholders to review corrective actions, and conducting follow-up audits to ensure error recurrence prevention. This position also provides financial support functions to the Director of Pharmacy, including high-alert drug notifications and weekly invoice comparisons.