Pharmacy Technician Auditor - Express Scripts-Detroit, MI

Cigna Group•Detroit, MI

About The Position

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.
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.

Responsibilities

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.