Business Audit - Senior Analyst

Job DescriptionAs 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.Required Qualifications- 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 60% 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 situationsCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues 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, religious belief, or other legally recognized reasons that prevents them from being 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 or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications- 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) claimsprocessing- 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)EducationHigh school diploma or GED requiredBachelor's Degree preferredBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2025-11-01