As a Regional Pharmacy Onsite Auditor, you will be an essential part to the Pharmacy Audit Department at CVS/Caremark. In this role, you will be based from your home and travel onsite to conduct claims audit pharmacies throughout multiple states by reviewing prescription claims billed and educating pharmacies on the findings. You will also analyze claims for fraud, waste, and abuse trends and report your findings to the corporate office.
To be successful in this role, you must have the ability to travel overnight approximately 40 percent of the time and able to maintain a corporate credit card. Overnight travel is required, ability to travel via car or air, transport a laptop computer to pharmacy locations, and stand for extended periods of time while in pharmacies.
- 3+ years of professional experience, preferably in a retail pharmacy setting, or in fields of pharmaceutical and/or pharmacy regulatory industry
- Must be able to travel up to 40% of the time. Travel includes flights, overnight stays, local travel, travel on short notice, and other travel deemed necessary by the company.
- Must possess valid and current driver's license.
- Must possess personal vehicle sufficiently reliable to meet the requirements of the job and is appropriately insured.
- Ability to handle difficult situations
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
- If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.
- If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.
- Candidate must have excellent time management skills
- Ability to work independently and make decisions with a self-starter mentality
- Ability to plan and appropriately schedule audits in advance
- Ability to plan travel on the company's site in a cost effective manner
- Knowledge of CVS Health (or other PBM) claims
- Knowledge of retail pharmacy operations including reading prescriptions and drug knowledge
- Excellent verbal and written communication skills
- Experience with MS Office, including Excel and Word
- Pharmacy Technician Licensure
- Certified Pharmacy Technician (PTCB)
High school diploma or GED required
Bachelor's Degree preferred
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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