Client Audit Specialist
4 hours 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 Specialist **Job Description**: **Responsibilities**: - Review and interpret assigned audit requests to determine scope, impacted business areas and stakeholders, and evidence necessary to fulfill and manage the audit request Develop and maintain key internal and external stakeholder relationships to effectively provide audit consultation, streamline work activity, create/drive efficiencies, and ensure consistent, timely, and accurate audit completion, reporting, or submission of deliverables - Monitor audit progress and proactively identify and mitigate risks (including performance guarantee implications) to audit completion; appropriately escalate to Audit Advisors, department leadership or operational stakeholders and provide remediation recommendations to prevent delays or future findings - Ensure stakeholders have a thorough understanding of their audit-related responsibilities, are accountable to producing deliverables accurately and on time, and are informed of relevant audit status updates or changes - Ensure thorough audit records are developed and maintained, with emphasis on accuracy, relevance, and timeliness; prepare necessary documentation for audit activities including deliverables, reports, findings and recommendations; provide clear and concise audit result communications to internal and external stakeholders - Integrate project management and organization capabilities by effectively communicating and leading audit strategy, deliverables, requirements, milestones and accountability, throughout the entire audit - Support department enhancement initiatives to ensure accurate and thorough training and procedural materials are available and maintained - 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 - 2 years of relevant work experience in audit, compliance or operations within a regulated environment - Must be eligible to work in the United States without need for work visa or residency sponsorship Additional Qualifications - Effective verbal and written communication, and presentation skills; ability to effectively distill complex information into clear and compelling presentations and leadership briefings - Strong interpersonal skills, with the ability to effectively facilitate meetings, resolve conflict, build consensus, establish rapport and collaborate effectively across departments, internally and externally, and at all levels within an organization; ability to confidently represent the business and interact with external entities - Demonstrated critical thinking and analysis skills, with proven ability to navigate ambiguous, complex and challenging situations while maintaining professionalism, tact, and empathy - Organization and prioritization skills, strong attention to detail, and the ability to simultaneously manage multiple, complex projects, under pressure and strict timeframes, without compromising quality - Agility and adaptability to change and navigate in a demanding, dynamic, fast-paced, intense, and matrix environment - Ability to use independent judgment and critical decision making in the analysis of audit processes and evidence - Intermediate to Advanced skills in Microsoft Office Suite (Word, Excel) Preferred Qualifications - Health insurance/PBM operations and/or contract audit experience - Experience with regulatory compliance for Medicare/Medicaid/Commercial or ACA drug benefit - Project management experience Minimum Physical Job Requirements - Minimal travel may be required - Ability to work a flexible schedule outside of Prime’s core business hours to occasionally 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 Compliance department Potential pay for this position ranges from $62,100.00 - $93,300.00 based on location, experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.
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