Pharmacy Benefit Manager Compliance Manger - Client Audit

Elevance Health•Cincinnati, MO

2d•Hybrid

About The Position

The Pharmacy Benefit Manager Compliance Manager – Client Audit is responsible for coordinating pharmacy compliance activities and initiatives across the PBM and the enterprise by maintaining department approved audit plan and implementing effective internal controls. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Requirements

Requires a BA/BS and minimum of 6 years experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Travels to worksite and other locations as necessary.

Responsibilities

Identifies, monitors, revises and tracks business unit processes and implementing procedures to ensure compliance with all related measures.
Identifies potential risks associated with PBM activities and ensures procedures are in place to minimize risks.
Partners with business units to ensure compliance with audit requirements.
Participates as compliance subject matter expert on all mandated projects; achieves business operational compliance with all related measures relative to HIPAA and SOX and Privacy and Security Office initiatives.
Conducts, directs, leads and facilitates all activities related to Internal and External (Regulatory and Client) audits and responds to findings.
Performs high level audit research, develops strategic plans and pro-actively anticipates business needs and requirements.
Develops and implements training and communication plans; manages and leads scheduled and ad-hoc compliance projects; provides and delivers compliance consultation services to the business unit.