CVS Health

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Med D Claims Audit Analyst

at CVS Health

Posted: 11/20/2019
Job Reference #: 1064753BR
Keywords: compliance

Job Description

Job Description
As a Reporting Analyst, you will to have gather, analyze data, and present the data on "live" client and compliance audits. In addition to validate the accuracy of information and ensure data is compliant with applicable policies and CMS regulations.

This position is responsible for conducting audits, monthly reports and ad-hoc reports for clients and government services. In this role, the analyst assumes responsibility for all aspects of assigned audits/tasks.

Audit work involves planning, fieldwork, reporting, and follow-up on all audit engagements. The analyst will conduct the assessment of internal controls based on walkthroughs, data analysis, and testing. The position is responsible for interacting with various levels of internal and external partners as well as clients, third party vendors and government agencies.

Duties and Responsibilities:
* Conduct the assigned audits/tasks
* Perform ad-hoc reporting requests
* Knowledge of regulatory requirements as well as business processes
* Lead meetings with the business units as needed for data request and testing
* Present walkthroughs of processes with internal/external partners, clients, third-party vendors and government agencies
* Track open audit issues and performs follow-up to evaluate the adequacy of remediation efforts
* Express ideas and information, both written and verbal, in a clear and concise manner
* Develop and maintain productive relationships with management and other staff, both in and outside the department
* Participate in new systems development, significant process changes and re-engineering efforts throughout the Company to monitor impacts to the control environment

Required Qualifications
* Strong analytical and problem solving skills
* Writing and presentation skills
* Demonstrate flexibility and adaptability to changing task priorities and work situations
* 6+ months of professional work experience

Preferred Qualifications
* 2+ years of overall experience within Medicare Part D Communications in a PBM setting
* Knowledge of healthcare/PBM regulations, including CMS requirements around Medicare Part D
* Strong time management, experience working in a fast paced environment, be an independent thinker, and set own priorities and possess strong communication skills
* Ability to work well within a team environment, serves as a liaison to internal partners, and execute against priorities set independently and stated by team in a timely manner

Bachelor’s degree required or in place of a degree, 8+ years of relevant experience

Business Overview
It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!