Pharmacy Technician Auditor - Express Scripts-Detroit, MI at The Cigna Group

Detroit, Michigan, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Mar, 26

Salary

0.0

Posted On

20 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Pharmacy Technician Experience, Analytical Skills, Audit Tools, Communication Skills, Organizational Skills, Mentoring, Database Applications, Spreadsheet Applications, Client Communication, Training, Evidentiary Data Analysis, Audit Planning, Report Development, Collaboration, Problem Solving, Attention to Detail

Industry

Hospitals and Health Care

Description

The job profile for this position is Quality Review and Audit Lead Analyst, which is a Band 3 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. The Pharmacy Auditor is responsible for identifying pharmacy audit risks using analytical skills and audit tools, and for developing and executing audit plans and the scope of procedures necessary to address those risks. The Staff Auditor will complete audits to address identified risks 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 required research and provide background knowledge to interpret the audit scope. As a Staff Auditor, this position may serve as a resource for less-experienced team members and work on special projects as needed. The Auditor role will support the Sr. Manager- Audit on some escalated issues and projects. Location: Candidate must be located in the Detroit, MI metro area and must be willing to travel locally and throughout the US for pharmacy audits up to 50% ESSENTIAL FUNCTIONS: Perform efficient and effective audits to produce results consistent with departmental policies and critical corporate goals while meeting or exceeding personal production goals. Performance of audits includes obtaining, analyzing, and appraising evidentiary data on which to base an informed, objective assessment of the accuracy and legitimacy of claims audited. Utilize personal knowledge of medications and available tools including the Enterprise Data Warehouse (EDW), Access, Excel, etc., identify pharmacies and claims representing audit risks and develop an audit plan, utilizing appropriate audit techniques, to efficiently and effectively address those risks. Develop and produce reports as required to meet needs of department management, Account Managers, pharmacies and chain audit contacts, clients and other stakeholders. Providing updates to management on current status of audits including any escalated issues. Prepare for and participate in client communications, including conference calls and on-site meetings, to present status updates of ongoing issues, results of completed audits, etc., for assigned clients. Perform special projects as assigned. Mentor less experienced team members to improve their understanding and skills by ensuring they are familiar with resource materials including manuals and systems. Responsible for the training of new associate auditors on departmental processes. Assist with post audit as required by management. Requirements: Bachelor's Degree preferred At least 2+ years of pharmacy technician experience in a retail, long term care, specialty, mail order or similar pharmacy setting or equivalent education. Certified Pharmacy Technician (CPhT) preferred. Proficient in database and spreadsheet applications, ie: Microsoft Excel, Access, Word. Excellent organizational, interpersonal, and communication skills. Ability to work well with all levels of internal and external contacts. Ability to handle sensitive or confidential information is critical. Ability to work with minimum management oversight while performing audits. Ability to work a flexible schedule to accommodate project deadlines. Ability and willingness to travel up to 50%. Reliable transportation for local travel for field audits within the metro area in which you live. Valid Driver's license required. ABOUT THE DEPARTMENT: The Pharmacy Operations Group is crucial to achieving our mission of helping to achieve a more sustainable health care system and better health for all. Members of this team are on the front line every day – interacting with patients, strategizing on improvements and efficiencies, and processing more than one million prescriptions that come through our world-class pharmacies and distribution facilities across the country. 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. 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. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Responsibilities

The Pharmacy Auditor is responsible for identifying pharmacy audit risks and developing audit plans to address those risks. They will complete audits, present findings, and mentor less-experienced team members.