Top 22 Pharmacy auditor Jobs

Pharmacy Network Auditor
RxSense —Boston, MA
- $74,000 - $110,000 a year
- Remote
- Microsoft Word
- 5 years
- Research
Quick Apply
5d
340B Auditor
The Alinea Group —Remote
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Disability insurance
- Health insurance
Quick Apply
Pharmacy Claims Auditor
Integrated Pharmacy Solutions —Pennsylvania
- $58,000 - $63,000 a year
- 8 hour shift
- Up to 50% travel
- Customer service
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
11d
Pharmacy Technician - Internal Auditor - FT - Days - MHW
Memorial Healthcare System —Pembroke Pines, FL
- Full-time
- Customer service
- 5 years
- Mid-level
Pharmacy Part D Auditor
Clever Care Health Plan —Huntington Beach, CA
- $80,000 - $90,000 a year
- Full-time
- Hybrid work
- Background check
- Bachelor of Science
- Mid-level
Pharmacy Technician - Internal Auditor - PT - Days - MSP
Memorial Healthcare System —Miramar, FL
- Part-time
- Customer service
- 5 years
- Mid-level
Auditor of Pharmacy Benefit Management - Remote
Gallagher Benefit Services —Rolling Meadows, IL
- $67,500 - $131,500 a year
- Full-time
- Remote
- Bachelor of Science
- HIPAA
- Mid-level
- Paid parental leave
- Health savings account
340B Pharmacy Analyst/Audit Specialist
MaineHealth —Portland, ME
- Email
- Remote
- Mid-level
- Accounting
- Associate's degree
- Paid parental leave
- Parental leave
4d
340B Contract Pharmacy Auditor / Program Specialist
Sunset Community Health Center —Yuma, AZ
- Contract
- CPR Certification
- Management
- Mid-level
Quick Apply
2d
Pharmacy 340B Program Audit Analyst - Full-Time, Days
UChicago Medicine —Chicago, IL
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Finance
Internal Auditor - 340B Corporate Finance - Contract Pharmacy - FT - Days - MHS
Memorial Healthcare System —Fort Lauderdale, FL
- Full-time
- Customer service
- 5 years
- Data analysis skills
Pharmacy Claims Auditor CPhT
Conduent Payment Integrity Solution Inc. —Miami, FL
- $57,000 a year
- Email
- Research
- Mid-level
- Windows
- Paid training
- Paid holidays
Accounting Clerk III, Pharmacy
Hendrick Health —Abilene, TX
- Part-time
- Mid-level
- Bachelor's degree
- Hospital experience
Director Pharmacy Compliance (Financial/Auditing)
Blue Cross Blue Shield Association —Washington, DC
- $113,572.92 - $153,590.12 a year
- Full-time
- Hybrid work
- 7 years
- CPA
- Customer service
- Paid holidays
- Health insurance
Pharmacy Audit Assistant / Technician
Topaz HR —Bardonia, NY
- $46,000 - $66,000 a year
- Full-time
- Computer literacy
- Writing skills
- Mid-level
PBM Audit Manager
MedWiz of New Jersey LLC —Cherry Hill, NJ
- Overtime
- Microsoft Excel
- Microsoft Outlook
- 3 years
Quick Apply
Account Executive- LPN Akron
CITYWIDE RX LLC —Columbus, OH
- $55,000 - $60,000 a year
- Weekends as needed
- Microsoft Excel
- Mid-level
- Driver's License
- Paid training
- Paid holidays
Quick Apply
4d
Senior Pharmacy Technician, Certified, Ambulatory Care-Audits
The University of Iowa —Iowa City, IA
- 8 hour shift
- High school
- Mid-level
- Windows
2d

Discover related jobs

Based on your search for pharmacy auditor jobs.

Pharmacy Benefits QA Analyst
SmithRx —Plano, TX
Strong communication skills via face-to-face meetings, conference calls and written correspondence. Ensures the quality and accurate analysis of benefit plan…
Quick Apply
Pharmacy Operations Manager (Remote)
MRIoA —Remote
Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social…
Quick Apply

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Account Executive- LPN Akron
CITYWIDE RX LLC —Columbus, OH
Valid driver's license and reliable transportation. Working under the general supervision of the Account Executive Manager, this role ensures that services are…
$55,000 - $60,000 a year
Quick Apply
4d

I want to receive the latest job alert for pharmacy auditor

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Pharmacy Network Auditor

RxSense -
Boston, MA

Quick Apply

Job Details

$74,000 - $110,000 a year
5 days ago

Qualifications

Performance Reporting

Full Job Description

We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.

As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem. With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.

Position Summary:

The Pharmacy Network Auditor is responsible for the maintenance and growth of the Pharmacy Network Audit program and processes at RxSense, including all internal pharmacy audits, and working closely with external
pharmacy audit vendors to ultimately detect, prevent and recover on Fraud Waste Abuse (FWA) occurrences.The Pharmacy Network Auditor is solely responsible for assuring compliance with client contract requirements,
pharmacy contractual compliance, and effectively communicating the program updates in real-time to leadership.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pharmacy Network Auditor evaluates, reports and monitors all aspects pertaining to Pharmacy Network Auditing services
The role will also serve as a subject matter expert within the Company regarding standard monitoring measures, auditing procedures, and best practices
Assess the risks outlined by audit vendor, perform appropriate audit procedures, and collaborate with pharmacy management to resolve issues in a timely and efficient manner
Draft and communicate audit findings and observations to internal stakeholders such as Finance and Client Success; Provide Quarterly Network Audit Performance Reports to the leadership to monitor Audit Program efficacy
Screen and summarize authorized vendor audit results in detail prior to initiating claim adjustments
Review results to determine details of fraudulent, erroneous, or abusive billing activity
Responsible for leveraging current BI Tools to analyze claims data for potential investigational FWA breaches of network pharmacies
Maintain audit documentation, and prepare statistical data for internal stakeholder review and action
Develops and updates Standard Operating Procedures (SOPs) for audit and FWA Programs
Collaborates with key stakeholders to support pharmacy network initiatives
Establish and maintain relationships with Implementations, Client Services, Benefit Administration, UAT/QA, IT, Product, Finance, Clinical Departments with focus on actively engaging the appropriate teams to enhance the Audit/FWA program

Qualifications:

Previous Pharmacy Audit Experience is required, understanding of the processes and industry related guidelines are mandatory
5+ years of experience in a Retail Pharmacy setting and/or Pharmacy Benefits Management organization
Strong understanding of the pharmacy claims processing ecosystem
Strong understanding of pharmacy relationships and NCPDP data extracts
Proficient knowledge and ability to leverage current reporting tools to identify audit and FWA issues proactively
Strong understanding of Pharmacy Network Standards and how to manage potential FWA issues via claims data
Proficient knowledge of URAC and CMS network requirements in addition to Federal and State level auditing network requirements
Ability to research, analyze and report on audit results and industry trends in FWA
Proven ability to work independently and drive results
Detail-oriented, ability to multitask, proactive thinker
Excellent written and verbal communication skills
Experience with presenting and or training
Proficiency in MS Word and Excel

Salary Range: $74,000 - $110,000

RxSense believes that a diverse workforce is a more talented and productive workforce. As such, we are an Equal Opportunity and Affirmative Action employer. Our recruitment process is free from discriminatory hiring practices and all qualified applicants are considered for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin. Neither will qualified applicants be discriminated against on the basis of disability or protected veteran status. We believe in the strength of the collaboration, creativity and sense of community a diverse workforce brings.

Quick Apply

Refine Your Search

pharmacy auditor jobs

Pharmacy Network Auditor

340B Auditor

Pharmacy Claims Auditor

Pharmacy Technician - Internal Auditor - FT - Days - MHW

Pharmacy Part D Auditor

Pharmacy Technician - Internal Auditor - PT - Days - MSP

Auditor of Pharmacy Benefit Management - Remote

340B Pharmacy Analyst/Audit Specialist

340B Contract Pharmacy Auditor / Program Specialist

Pharmacy 340B Program Audit Analyst - Full-Time, Days

Internal Auditor - 340B Corporate Finance - Contract Pharmacy - FT - Days - MHS

Pharmacy Claims Auditor CPhT

Accounting Clerk III, Pharmacy

Director Pharmacy Compliance (Financial/Auditing)

Pharmacy Audit Assistant / Technician

PBM Audit Manager

Account Executive- LPN Akron

Senior Pharmacy Technician, Certified, Ambulatory Care-Audits

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for pharmacy auditor

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected