Client Audit Senior Manager

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
CVS Health is seeking a dynamic and experienced professional to join our team in a Sr Manager role focused on Client Audit State-Initiated. The Sr Manager of Client Audit State-Initiated will lead a team of professionals responsible for coordinating, managing, tracking, reviewing, researching, and assisting with multiple complex financial audits initiated by Regulators or contracted third parties. In this position, the Sr. Manger will work closely with clients, governmental auditors, the client account team, legal, and many other internal departments to ensure the completion of requested audits with consistency and minimal disruption to the business.

As a Senior Manager, you will be responsible for the team’s timely and satisfactory resolution of exceptions identified during the audit process, specifically related to delegated PBM services. This position will also be expected to identify process enhancement opportunities to reduce or eliminate risk of future audit exceptions, as well as ensuring any concerns / issues are raised immediately to senior management. This client-facing position will also be responsible for leading and executing complex audits across all lines of business, including Commercial, Medicaid, and Exchange. In this role, you will bring a deep understanding of Pharmacy Benefit Manager (PBM) services, strong project management skills, and the ability to lead cross-functional teams in a fast-paced, high-stakes environment. Additional skills must include abilities to analytically identify, track and encourage business owners in process enhancement opportunities to reduce risks, as well as researching claim specific questions.

Key Responsibilities:

• Work directly with the governmental auditors, the client and all the internal business areas involved in the audit

• Manage the workload successfully as there is no room for error with government audits and these audits come in waves across many clients at the same time which the position needs to be able to juggle all the competing priorities

• Analyze audit activities to evaluate performance of the organization and staff in meeting annual objectives

• Have a deep knowledge base around Medicaid, Exchanges and Commercial lines of business

• Relationship management skills: capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously

• Work independently with limited direction from the Lead Director

• Coordinate, manage, track the audits from start to closure

• Work with the team to resolve any alleged issues, working strategically and achieving results

• Work with the right business leaders to ensure responses are accurate and senior leaders are aware of any issues in accordance with regulatory timelines

• Understand the intricacies of pharmacy services, to support the audit work with the auditors, answering their questions correctly and confidently

• Identify process enhancements, as well as any gaps in controls within the business areas being audited

• Raise the appropriate items to senior leaders and doing so timely

• Documenting correspondence with internal partners, clients, and auditors

• Tracking all audit progress to ensure that all deliverables are provided by due dates

Required Qualifications

• 7+ years of prior relevant experience in audit, project management, or financial advisory role

• 2+ years of leadership experience

• 3+ years of pharmacy claims experience

• Proven ability to manage multiple priorities under tight deadlines with minimal supervision

• Experience presenting to senior leadership

• Ability to interact effectively with Government Auditors and Clients while under pressure during an audit is a must

• Willingness to travel up to 10% (including plane)

Preferred Qualifications

• Past Project Management experience is des