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Manager, Client Audits job in New York

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New York, New York - NY Capital Rx

Job Ref:	3037047
Employer:	Capital Rx
Sector:	Health Insurance
Qualifications:	Unclassified
Job Type:	Full Time
Salary and Benefits:	$90,000 - $110,000 per year
Remote:	No
Location
Country:	United States
State/Province/County:	New York - NY
City:	New York
Post Code:	10007
Map:	(Show on map)
Description
Location: Remote (For Non-Local) or Hybrid (Local to NYC area) Position Summary: The Manager, Client Audits role primarily focuses on project management of client audits for the organization. The Manager, Client Audits will be the liaison between the external auditor with all subject matter experts and stakeholders within the organization in order to conduct the intake, provide necessary documentation, and respond to audits in a timely manner. This role will also create the internal processes necessary for client audits, as well as the corresponding SOPs. Position Responsibilities: Manage the intake of client audits, including kick off call, for scope and timing. Collaborate with internal subject matter experts and stakeholders in order to provide accurate and necessary data and documentation to auditors. Work with internal departments including Client Account Management, Pricing and Rebates, as well as Legal, as needed on any audit issues. Manage the relationships with external auditors and consultants including handling any relevant/applicable questions from the auditors, and setting up meetings with auditors to review outstanding findings. Support client contracting, including validation that pharmacy and client contract terms align and raise any global concerns that result for any audit. Oversee the client audit process, including the determination of standards and SOPs. Review audit findings and confirm final audit results and settlement amounts for each client audit, including providing Settlement Agreements. Maintain and track status and findings for all client audits. Support general business needs, as required. Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Required Qualifications: Five to ten years of experience in PBM, healthcare, audit, pharmacy, and project management. Ability to meet all internal and external deadlines in a dynamic environment, shifting priorities as needed. Detail oriented. Ability to coordinate across the organization to identify financial, operational and contract risk. Proven track record of working in a fast-paced environment, managing multiple tasks at once and having a go-get attitude to provide persistent outreach to internal and external parties to close out audits. Strong communication skills with the ability to develop effective working relationships with auditors/ consultants and internal and external stakeholders. Familiarity with PBM contracting preferred. BA required; Advanced certifications in an analytical capacity (MBA, actuarial certifications, MA in statistics) or project management preferred. Base Salary: $90,000 - $110,000 Nothing in this position description restricts management's right to assign or reassign duties and responsibilities to this job at any time. About Capital Rx Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation's electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company's cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare. Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

ref: (3037047) 16 days ago

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