Audit Manager

🕒 il y a 11 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

👻 Score fantôme 12%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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TrueScripts Management Services

Site WebLinkedInTous les Emplois

51 - 200 employés

Fondée en 2014

🏥 Santé

💼 Conseil

⚕️ Assurance santé

Healthcare • Consulting • Healthcare Insurance

TrueScripts Management Services est dédiée à fournir des services de gestion des prestations pharmaceutiques exceptionnels. Avec un accent sur la réalisation d'économies maximales et des soins remarquables, TrueScripts collabore étroitement avec les membres, les clients, les courtiers et les prescripteurs pour offrir des solutions personnalisées et sur mesure. L'entreprise est fière de sa transparence et de son efficacité, offrant un délai de traitement de 24 à 48 heures pour les demandes d'autorisation préalable et un engagement envers le service client, garantissant que des personnes réelles sont disponibles pour aider dans plus de 99 % des cas.

Description

• Lead and manage TrueScripts’ comprehensive audit program • Establish an annual audit calendar covering regulatory, client, vendor, internal, and other required audits • Coordinate audits from initiation through final resolution • Develop audit plans, timelines, evidence requests, testing approaches, and deliverables • Maintain centralized documentation of audit requirements, evidence, findings, responses, and remediation activities • Monitor audit deadlines and identify risks to successful completion • Establish consistent audit processes, standards, templates, and controls • Coordinate regulatory and healthcare-related audits, including Market Conduct Audits and applicable state and federal examinations • Partner with Compliance and Legal to interpret audit requirements and prepare organizational responses • Coordinate client audits and information requests and review responses for completeness and consistency • Conduct internal audits, process reviews, and control assessments based on risk and regulatory requirements • Track audit findings and corrective action plans, establish root causes and target dates, monitor remediation, and escalate overdue or high-risk items • Support claims and PBM audits involving claims configuration, adjudication, pricing, eligibility, benefits, reporting, prior authorization, and pharmacy networks • Develop audit readiness checklists and documentation standards • Improve and automate evidence collection, testing, reporting, audit tracking, and workflows • Lead and develop audit team members as the function grows • Build relationships with business leaders and serve as a trusted audit advisor • Promote accountability, transparency, continuous improvement, and risk awareness

🎯 Exigences

• Bachelor’s degree or equivalent demonstrable experience in Accounting, Finance, Business, Healthcare Administration, Compliance, or related field • 5+ years of experience in auditing, compliance, healthcare operations, PBM, insurance, or related field • Experience managing audits from planning through final resolution • Experience with regulatory and client audits, preferably within the healthcare field • Strong understanding of audit methodologies, internal controls, risk assessment, and corrective action processes specific to audits within the healthcare sphere • Ability to analyze complex operational processes and identify risks and control gaps • Strong project management and organizational skills • Excellent written and verbal communication skills • Ability to manage multiple audits, competing priorities, and tight deadlines • Understanding of and adherence to Confidentiality and Personal Health Information (PHI) Guidelines • Ability to sit, use hands and fingers, and type for up to eight hours in a workday

🏖️ Avantages

• A wide range of health insurance options including medical, dental and vision • A strong salary and bonus program • A robust 401k and company match • ESOP participation with annual stock allocations through a qualified retirement plan • Wellness program including financial incentives, chiropractic and massage services, and fitness stipends • A cohesive, family-based culture • Charitable contributions and volunteer time • Lots of celebrations • Flexible “8-5” workweek