Posted on Thursday, September 13, 2007
Senior Auditor/Analyst, Medicare Part D - Express Scripts

POSITION PROFILE

Express Scripts makes the use of prescription drugs safer and more affordable for more than 50 million people across the United States and Canada. Thousands of managed-care organizations, large employers, insurance carriers, third-party administrators, labor unions, and municipal and state governments rely on the company for innovative solutions to manage pharmacy-benefit costs and enhance their members' quality of care. The Company is headquartered in St. Louis, MO, and maintains major administrative facilities in Bloomington, MN, East Hanover, N.J., and Tempe, AZ. We have the following opportunity located in our St. Louis locatio

Senior Auditor/Analyst, Medicare Part D

This position will identify network pharmacy audit risks using analytical skills and audit tools and develop and execute audit plans and scope of procedures determined necessary to address those risks for assigned Part D clients. Develop and utilize new programs and analytical procedures, and utilize existing tools and knowledge of medications to identify pharmacies, members, physicians and claims representing audit risks and potential fraud, waste, and abuse in the Medicare Part D benefit. Perform efficient and effective on-site and investigational audits to produce results consistent with departmental policies and critical corporate goals while meeting or exceeding production goals. Prepare formal written reports and provide expert testimony expressing opinions on the findings of the audits performed, client impact, ESI risk, etc. as needed. Provide expert testimony as Auditor-in-Charge of investigations for internal and external proceedings. Prepare for and take lead role in client communications and present updates for assigned cliets. Identify and perform special projects as needed.

QUALIFICATIONS

• BA/BS degree or equivalent work experience; minimum 2 years auditing experience required; pharmacy/healthcare audit, or nursing experience preferred
• Certification strongly preferred (i.e., Certified Fraud Examiner, RN, Certified Pharmacy Technician or similar)
• Highly proficient in data warehousing, database and spreadsheet applications
• Excellent organizational and interpersonal skills
• Excellent verbal and written communication skills, including ability to present to clients and internal stakeholders
• Ability to assimilate and maintain extensive detailed information required to support audit conclusions
• Ability to work well with senior management and high level external contacts
• Ability to handle sensitive or confidential information is critical
• Ability to work with minimum management oversight on multiple projects with competing priorities
• Ability to work a flexible schedule to accommodate significant travel and project deadlines

We offer a competitive salary and excellent benefits package. For consideration, please apply via http://www.express-scripts.com/ourcompany/careers/, to job ID 4204. Express Scripts is an Equal Opportunity Employer

# posted by ASQ St. Louis @ Thursday, September 13, 2007