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Pharmacy Technician Auditor, Lead Analyst - Express Scripts at Cigna

Posted in General Business 5 days ago.

Type: Full-Time
Location: Miami, Florida





Job Description:

POSITION SUMMARY

The Pharmacy Technician Auditor, Lead Analyst is primarily responsible for using analytical skills and audit tools to identify network pharmacy audit risks and develop/execute audit plans and scope of procedures determined necessary to address those risks. Under a moderate level of guidance, the Pharmacy Technician Auditor performs complex on-site network pharmacy audits in order to correct risks identified, protect client assets, and present findings to key internal and external stakeholders. As a Pharmacy Technician Auditor, you will assist in mentoring and developing less experienced Audit Team Members.

ESSENTIAL FUNCTIONS


  • Perform efficient and effective audits to produce results consistent with departmental policies and critical corporate goals while meeting or exceeding personal production goals. Performance of audits includes obtaining, analyzing, and appraising evidentiary data on which to base an informed, objective assessment of the accuracy and legitimacy of claims audited.

  • Utilizing personal knowledge of medications and available tools including the Enterprise Data Warehouse (EDW), Access, and Excel along with other systems.

  • Identify pharmacies and claims representing audit risks and develop an audit plan, utilizing appropriate audit techniques, to efficiently and effectively address those risks.

  • Develop and produce reports as required to meet needs of department management, Account Managers, pharmacies and chain audit contacts, clients and other stakeholders. Providing updates to management on current status of audits including any escalated issues.

  • Prepare for and participate in client communications, including conference calls and on-site meetings, to present status updates of ongoing issues, results of completed audits, etc., for assigned clients.

  • Perform special projects as assigned.

  • Mentor less experienced team members to improve their understanding and skills by ensuring they are familiar with resource materials including manuals and systems. Responsible for the training of new associate auditors on departmental processes.

  • Assist with post audit as required by management.

QUALIFICATIONS


  • Bachelor's Degree or equivalent experience.

  • Valid driver's license.

  • Travel up to 50%.

  • 2-5 years of pharmacy technician experience in a retail, long term care, specialty, mail order or similar pharmacy setting or equivalent education or Master's Degree.

  • Certified Pharmacy Technician (CPhT).

  • Proficient in database and spreadsheet applications, ie: Microsoft Excel, Access, Word.

  • Excellent organizational, interpersonal, and communication skills.

  • Ability to work well with all levels of internal and external contacts.

  • Ability to handle sensitive or confidential information is critical.

  • Ability to work with minimum management oversight while performing on-site audits.

  • Ability to work a flexible schedule to accommodate project deadlines.

  • Willingness to travel.

This role is WFH/Virtual which allows most work to be performed at home or on occasion at a Cigna office location. Employees must be fully vaccinated if they choose to come onsite.

ABOUT THE DEPARTMENT

The Pharmacy Operations Group is crucial to achieving our mission of helping to achieve a more sustainable health care system and better health for all. Members of this team are on the front line every day - interacting with patients, strategizing on improvements and efficiencies, and processing more than one million prescriptions that come through our world-class pharmacies and distribution facilities across the country.

ABOUT EXPRESS SCRIPTS

At Express Scripts, we dare to imagine a better health care system, and we're driven to make it happen. Where some see obstacles, we see possibilities. We're challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all.

We have always acted first to take on the toughest challenges. We uniquely partner across the health care ecosystem to uncover opportunities, take action, advance health care and deliver better outcomes - like no one else can. We believe health care can do more. We are Champions For BetterSM.

Express Scripts, part of Cigna Corporation, unlocks new value in pharmacy, medical and beyond to further total health for all.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.





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