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 SummaryJoin our dynamic Pharmacy Audit group as the Senior Manager of Pharmacy Post Audit, where you will lead a dedicated team that supports various groups within the company, including pharmacy performance, network account management, adjustment services, and more. This role is pivotal in ensuring compliance with state pharmacy audit laws and involves leading a team that reviews onsite and investigational audits against applicable State Audit Legislation nationwide. Your team will determine if audits were performed within the requirements dictated by State Law, address pharmacy appeals to audits, and report results both internally and to the audited pharmacies. Additionally, your team will oversee all pharmacy audit correspondence, review appeal documentation submitted by pharmacies, and prepare internal post-audit reports.As the Senior Manager, you will oversee processes to track, monitor, and report Caremark's audit activities and findings to our network pharmacies and senior leaders. You will work closely with chain and PSAO contacts to develop and maintain strong working relationships and collaboration as it pertains to pharmacy performance and pharmacy audits.In this role, you will be responsible for actively managing workload and dynamically redeploying human resources to meet fluctuations in demand. You will review executed pharmacy audit legislation and oversee custom audit processes as needed to ensure compliance. Additionally, you will consult with other areas in the department and act as a subject matter expert in areas related to Pharmacy Audit, pharmacy audit legislation, post-audit procedures, and more. You will also be the key contact for all Chain and PSAO headquarters regarding onsite and investigational audit activities. Key Responsibilities:

• Lead and supervise a team of employees, providing continuous feedback and support.
• Plan, organize, and execute goals, ensuring alignment with department objectives .
• Monitor employee performance and productivity through KPIs and various reports.
• Generate and manage department reports and address inquiries from various stakeholders.
• Create and maintain Onsite/Post Audit's Policies and Procedures and summary templates.
• Manage documentation retention and ensure CMS compliance.
• Oversee and m onitor state pharmacy audit law legislation, partnering with the Legal department to understand and update state audit law compliance tracking.
• Oversee departmental claim adjustments and finances, ensuring accuracy and compliance with policies and regulations .
• Collaborate with others to innovate, resolve difficulties, and achieve common goals.
• Act as Business Product Manager for developing an external-facing client product.

• A background in pharmacy and/or audit.
• In-depth knowledge of pharmacy audit and State Pharmacy Audit Laws , and experience working with attorneys interpreting legislation
• High proficiency in working with large data sets and understanding operational SOX controls.
• The ability to work in a fast-paced, dynamic environment with tight deadlines.
• Excellent communication and collaboration skills.
• Experience in setting up new processes and executing against them.
• The ability to communicate complex processes in an easy-to-understand way .
• Experience extracting, manipulating, and analyzing data to draw conclusions or troubleshoot issues. The ability to appropriately prioritize, ensuring focus on the highest impact activities.

• 7+ years of PBM, audit, or pharmacy experience
• Licensed Pharmacist

• 10+ years of PBM experience
• 2+ years of pharmacy experience
• 5+ years of audit experience
• 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