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 SummaryAs a Pharmacy Audit Senior Manager, you will lead a dynamic, multifaceted experienced team to represent the Pharmacy Audit Department and meet client performance standards. You will support pharmacy audits for all lines of business, in coordination with your assigned clients and within state legislature requirements. This role involves high visibility, direct client, and pharmacy contact. You will work as an integral member of our Pharmacy Audit Department, communicating directly with clients, tracking current and past audits, generating reports, and facilitating Fraud, Waste, and Abuse meetings. Additionally, you will be responsible for representing the pharmacy audit department through client presentations, ensuring clear and effective communication of complex concepts. Key Responsibilities:

• Develop, coach, and mentor your team's client-facing and client relationship-building skills.
• Collaborate and coordinate with other internal departments to resolve issues.
• Develop relationships internally and externally to represent the Pharmacy Audit department and promote alignment, provide education, and ensure overall client satisfaction.
• Oversee departmental claim adjustments and finances, ensuring accuracy and compliance with policies and regulations .
• Communicate complex concepts to a variety of audiences.
• Assist with tracking of audits and generating monthly, quarterly, and ad-hoc reports.
• Provide ongoing audit support for clients and work collaboratively with account teams on general client issues.
• Support client inquiries/escalations and client relations as it pertains to pharmacy audits, including financial aspects, regulatory requirements, and contractual obligations.
• Conduct data mining to identify pharmacies that warrant additional review and provide expert analysis and reports to highlight audit efforts.

• 7+ years of PBM, audit, or pharmacy experience
• 7+ years of professional related business experience.

• 10+ years of PBM experience
• 2+ years of pharmacy experience
• 5+ years of audit experience
• 2+ years direct client-facing experience.
• Strong interpersonal and communication skills, including verbal/written communication and data presentation skills.
• Understanding of SQL databases and querying skills
• Familiarity with state and federal pharmacy audit legislation
• Strong motivational and team leadership skills
• Deep understanding of audit operations.
• Familiarity with contracting.
• Project management experience.

• Bachelor's Degree required or equivalent work experience

• Licensed pharmacist of pharmacy technician is preferred