Pharmacy Audit Lead: Lead Audits & Optimize Recoveries

Capital Rx Inc.; Charlotte (NC); Hybrid; USD 92.000 - 103.000; Vollzeit

Zusammenfassung

Judi Health in New York, NY (hybrid) seeks a Pharmacy Audit Lead to guide audits, assign work, monitor quality, and support disputes for clients. This player-coach will also conduct audits, prepare reports, and drive process improvements across the team.

You will collaborate with Compliance, Legal, and Client Services, manage workflow, and ensure accuracy of recoveries and documentation while meeting client commitments and capacity targets.

Qualifikationen

• Bachelor's degree or equivalent relevant experience required.
• Active pharmacy technician certification or registration required.
• 4–6 years of pharmacy or PBM auditing experience, including direct audits and team lead experience.
• Strong knowledge of pharmacy operations, billing, audit and documentation requirements, and contracts.
• Strong analytical, organizational, problem-solving, documentation, communication, and prioritization skills.
• Proficiency in Microsoft Excel, Word, and applicable audit, workflow, and reporting tools.

Aufgaben

• Assign, rotate, and prioritize audit work; set expectations and maintain operating standards.
• Monitor inventory, productivity, deadlines, quality, capacity, and staffing needs; resolve barriers and elevate risks.
• Lead team huddles and case reviews; coach and train staff; serve as first escalation point for audit issues.
• Maintain pharmacy audit SOPs, procedures, job aids, and templates, including version control and scheduled reviews.
• Personally conduct pharmacy audits, including claims and documentation review.
• Validate findings, evidence, recovery calculations, reports, and correspondence before finalization.
• Manage audit inventory, daily claims review, deadlines, disputes, appeals, recoveries, vendor work, and client deliverables.
• Prepare audit reports, trend summaries, and client or management materials.
• Use audit results and metrics to improve workflows, controls, systems, turnaround times, and team efficiency.

Kenntnisse

Analytical

Organizational

Problem-solving

Documentation

Communication

Prioritization

Ausbildung

Bachelor's degree in Business, Accounting, Healthcare Administration, or related field

Tools

Microsoft Excel

Word

Audit tools

Jobbeschreibung

Judi Health in New York, NY (hybrid) seeks a Pharmacy Audit Lead to guide audits, assign work, monitor quality, and support disputes for clients. This player-coach will also conduct audits, prepare reports, and drive process improvements across the team.

You will collaborate with Compliance, Legal, and Client Services, manage workflow, and ensure accuracy of recoveries and documentation while meeting client commitments and capacity targets.