Senior Client Audit Analyst

Job DescriptionCVS Health is currently looking for a dynamic individual to join our team in an Sr. Analyst role. This is a client facing project management / auditor position that is responsible for coordinating, managing, tracking, reviewing, researching and assisting with multiple complex health plan audit activities initiated by CMS. In this position, the Sr. Analyst will work closely with health plan clients, various Government auditors, the client account team, legal, and many other internal departments to ensure the completion of requested audits with consistency and minimal disruption to the business. This position needs to be able to manage multiple audits at the same time with short turnaround times. The Sr. Analyst will be responsible for the timely and satisfactory resolution of exceptions identified during the audit process, specifically related to pharmacy claims. This includes having a basic knowledge base around pharmacy claim adjudication principles, such as (but not limited to) benefit setup, discount pricing, prior authorizations, and accumulation tracking in order to review and respond to all the auditor's questions in a short window of time. Skills must include abilities to analytically identify and research claim specific questions. As a Sr. Analyst of Client Audit, you will be responsible for the following:-Work directly with the government auditors, the client and all the internal business areas involved in the audit-Manage the work load successfully as there is no room for error with government audits and these audits come in waves across many clients at the same time which the position needs to be able to juggle all of the competing priorities-Coordinate, manage, track the audits from start to closure-Review and researching all questions from the auditor and client -Respond back to the auditor / client-Raise appropriate at risk items to the Sr. Manager timely-Documenting correspondence with internal partners, clients, and auditors-Tracking all audit progress to ensure that all deliverables are provided by due datesThe ideal candidate will possess the following:-A basic knowledge/understanding of pharmacy claims -Ability to actively seek new ways to grow and be challenged -Critical thinking which translates into strategic actions-Easily adapting to change -Excellent verbal and written communications skills -Strong Project Management skills that include the ability to adapt and deal effectively in dynamic, possibly unpredictable, environments while efficiently managing multiple projects from initiation through to completion. A working contributor responsible for each project's success. -Ability to interact effectively with third-party auditors and clients while under pressure during an audit is a must. Strong tolerance for ambiguity and stress-Strong ability to maintain attention to detail and organizational skills.Pay RangeThe typical pay range for this role is:Minimum: 43,700Maximum: 100,000Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications2 or more years of experience in audit, project management, Med-D related functions and/or financial analysisPreferred QualificationsPast project management experience is desired. Proficiency in Microsoft Word, Excel, PowerPoint, SalesForceEducationBachelor's Degree or equivalent work experience required.Business OverviewBring 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. 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. 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.

Created: 2025-11-15