Client Audit Specialist

Prime Therapeutics LLC Bloomington , MN 55431

Posted 2 months ago

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Client Audit SpecialistJob Description

In support of regulator, client, and third-party audits, the Client Audit Specialist is accountable for managing audits of low to medium complexity and may assist an Advisor or Manager with managing audits of high complexity. Additionally, the Specialist is responsible for performing routine and ad hoc pre-audit assessments of operational processes, supporting documentation, and associated data files for assigned areas of responsibility to proactively assess for compliance with regulatory and/or contractual requirements including adherence to departmental processes. This position may also perform proactive ongoing assessments of specified audit types separate from an actual external audit.

Responsibilities

  • Assess and score operational processes, supporting documentation, and data files (leveraging formalized audit criteria when available, or audit criteria from a recent audit) for adherence to state and federal regulations, accreditation standards, contractual requirements, departmental policies, procedures and guidelines; scope to be determined based on client and audit requirements as well as visibility enforcement and acumen necessary

  • Verify the completeness and accuracy of planned audit deliverables upon receipt from the respective business owner(s)

  • Complete audit work papers by documenting results of reviews performed and communicate audit results as required

  • Draft pre-audit summary report detailing review observations/findings, and associated regulatory requirements

  • Under the supervision of Client Audit Manager, develop a comprehensive working knowledge of regulatory requirements/standards, audit protocols, common findings, and best practices for assigned areas of responsibility

  • Maintain the Client Audit Database for audit activity including reports, findings, recommendations, and internal Corrective Action Plan documentation

  • Continually monitor progress of assigned audits and report to Client Audit Manager on audit status, challenges, and potential risks; project manage audits to timely completion of audit deliverables through to audit closure

  • Coordinate audit activities when Prime is audited or reviewed by a regulator, client, or third-party entity; serve as a liaison between the Client Audit Management department and the auditing entity

  • Assist in projects to drive the Client Audit function towards continuous readiness for assigned audit types

  • Other duties as assigned

Minimum Qualifications

  • Bachelor's degree in Business, Health Care Services or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

  • 3 years of relevant work experience in audit, compliance or operations within a regulated environment, with at least 1 year of experience directly supporting audits

  • Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

  • Strong interpersonal communication skills; ability to effectively influence others at all levels of the organization

  • Ability to disseminate and present complex information

  • Proven organizational skills with the ability to effectively work on multiple projects simultaneously

  • Ability to adapt to change and navigate in a dynamic, fast-paced environment

  • Ability to understand and interpret contracts as related to assigned area of responsibility

  • Ability to use independent judgment and decision-making in the analysis of processes and problems/errors

  • Intermediate to Advanced skills in Microsoft Office Suite (Word, Excel)

  • Demonstrated technical expertise in performing quality reviews along with analysis of results

Preferred Qualifications

  • Health care/PBM experience

  • Pharmacy operations and contract audit experience

  • Medicare/Medicaid regulatory compliance experience

  • Project Management experience

  • Certification or licensure in a related area of expertise (e.g., Pharmacy Technician, clinical review, Certified Internal Auditor, CCEP or HCCA certification)

Minimum Physical Job Requirements

  • Ability to travel up to 15% of the time

  • Ability to work a flexible schedule outside of Prime's core business hours to accommodate different time zones and during critical client audits

  • Constantly required to sit, use hands to handle or feel, talk and hear

  • Frequently required to reach with hands and arms

  • Occasionally required to stand, walk and stoop, kneel, and crouch

  • Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

Reporting Structure

  • Reports to a Manager in the Client Audit Management department

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage qualified minority, female, veteran, disabled, and other diverse candidates to apply and be considered for open positions.


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Client Audit Specialist

Prime Therapeutics LLC