Pharmacy Audit and Compliance Analyst

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Recruiting.com

WebsiteLinkedInAll Job Openings

11 - 50 employees

🎯 Recruiter

☁️ SaaS

🤝 B2B

💰 Private Equity Round on 2006-06

Recruitment • SaaS • B2B

Recruiting. com is a recruitment platform that collects personal and non-personal information from job seekers to be used by recruiters and hiring managers. Users can submit their resumes or fill out a short form to be considered for current and future job opportunities. The site emphasizes user privacy and allows users to manage their personal data, including modifying, changing, and deleting their information. Recruiting. com securely stores user data until they request deletion, providing a comprehensive recruitment solution for both job seekers and employers.

📋 Description

• Responsible for tracking, trending and coordinating all incoming Payer audit correspondence • Provide expert audit assistance to customers including proactive audit prevention tips • Conduct enhanced screening of prospect customers seeking Network affiliation • Identify high risk accounts via the pharmacy performance analytics system • Work closely with other internal departments in identifying high risk accounts • Responsible for maintaining good working relationships with internal and external partners • Responsible for acquiring knowledge of industry audit trends and compliance requirements • Successfully completes special projects as assigned • Performs related duties as assigned

🎯 Requirements

• Requires completion of a four-year bachelor’s degree program or equivalent combination of experience and education • Normally requires a minimum of four (4) years of experience • Prior pharmacy background required • Strong knowledge of third party billing and experience with private health plans and government programs are required • Experience with pharmacy audits, pharmacy compliance, and risk mitigation a plus • Certified or State Licensed Pharmacy Technician desired

🏖️ Benefits

• Medical, dental, and vision care • Backup dependent care • Adoption assistance • Infertility coverage • Family building support • Behavioral health solutions • Paid parental leave • Paid caregiver leave • Professional development resources • Mentorship programs