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Senior Manager of Medicare Pharmacy Audit Programs

AT CVS Health
CVS Health

Senior Manager of Medicare Pharmacy Audit Programs

Scottsdale, AZ

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary

We are seeking a dynamic and experienced leader to join our team as a Senior Manager, overseeing a team of 10 auditors. This role is pivotal in conducting and building Medicare Pharmacy Audit programs for our PBM clients. The ideal candidate will be passionate about leading a diverse team and driving innovative audit programs that cater to the unique needs of our clients.As the Senior Manager, you will be responsible for developing and implementing a variety of audit programs, ensuring that each team member is engaged in different and exciting projects. Your leadership will be crucial in motivating, coaching, and inspiring your team to achieve excellence in their work. You will promote our company's values and foster a collaborative and supportive work environment.In this role, you will oversee targeted retrospective audit programs and various types of audits that recover significant financial assets annually. Your work will have a high degree of business impact, as the results of your team's audits can influence client retention and regulatory compliance. You will also play a key role in client-facing presentations, direct client requests, and fostering relationships with both internal and external stakeholders.The ideal candidate will possess a strong understanding of Medicare regulations, pharmacy operations, and audit processes. You will be adept at making critical business decisions, solving complex problems, and driving continuous improvement in audit methodologies. Excellent verbal and written communication skills and the ability to work independently while embracing a team-oriented philosophy are essential.Join us in this highly visible and impactful role, where you will have the opportunity to lead a talented team, innovate audit programs, and contribute to the success of our PBM clients.Required Qualifications

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-7+ years of PBM, audit, or pharmacy experience

Preferred Qualifications
-10+ years of PBM experience

-2+ years of pharmacy experience

-5+ years of audit experience

-Understanding of SQL databases and querying skills

-Strong understanding of the federal Medicare program and Medicare D regulations

-Strong motivational and team leadership skills

Education
Bachelor's Degree or equivalent work experiencePay Range

The typical pay range for this role is:$75,400.00 - $165,954.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit Benefits | CVS HealthWe anticipate the application window for this opening will close on: 06/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Scottsdale, AZ, USA
Job ID: CVS-R0464593
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program