Audit Project Manager in Saint Paul, MN

The Company is located in St. Paul, Minnesota, which specializes in the pharmacy and benefit management arenas. The company's goal is to provide industry-leading insight that guides plan sponsors through the complexities of the healthcare benefit market. From prescription benefit proposal analysis and audits to on-going utilization review, The Company's comprehensive approach combines advice, advocacy and action, along with meticulous attention to detail and follow through.
The Company's experienced staff of over 40 employees represent over 450 years of pharmacy and benefit management expertise including PBM operations, clinical, finance/underwriting, and implementation, plus experience in community pharmacy, pharmaceutical manufacturing, and sales. Knowledge of the industry from the inside combined with keen financial acumen gives The Company a strong competitive advantage.
The Company recognizes that talent is the key to its success. The company is seeking an AUDIT PROJECT MANAGER to join their team.
Position Overview
The Company has an immediate opening for an Audit Project Manager to join its Audit department. This is a full-time position. The Audit Project Manager will be the main client lead for Audit project implementation. This individual will be responsible for project delivery for several client and project teams.
The person in this position must understand plan policies and procedures (P & P) and the ability to perform gap analysis. Perform client's work process evaluations and create project documents for internal/external delivery. Also able to provide appropriate technical, audit, compliance and operational expertise to each client engagement.
Responsibilities/Accountabilities
Leadership
- Create and maintain technical project documentation internally and for external delivery, including detailed delivery schedules, weekly status reports and project plans
- Assist in staffing/tracking project teams based on available internal/external resources
- Understand and implement healthcare and related data security requirements for the transmittal, storage, and processing of sensitive client business and health information
- Understand and implement healthcare related compliance guidelines and the ability to analyze, process, and interpret data within the constraints for current and anticipated regulatory requirements
- Ability to understand, comprehend and consult on complex systems including integration points, logic and code
Client Satisfaction and Perception of Value
- Responsible for maintaining active client communication to manage expectations and deliverables, ensure satisfaction, and lead necessary change efforts effectively
- Ability to understand client IT environments and contribute to initial data requests/review incoming source documentation from clients
- Ability to provide appropriate technical, audit, compliance and operational expertise to each client engagement
Business Development
- Help to secure client relationships and sell new services in order to assist clients in achievement of their data validation goals
- Help to ensure the retention of clients and associated revenue related to data validation services
- Assist in the negotiation of client contracts and consummation of written contracts for data validation services
- Ensure timely review of proposals, contracts and marketing materials related to data validation services
Knowledge and Qualifications
- Bachelor's degree, preferably in Information Systems or Computer Science
- 10 years minimum experience in healthcare related industries and/or PBMs with at least 5 years experience or associated knowledge of Medicare/Medicaid and related services including operational and clinical areas of the programs
- Minimum of 5 years in project/program leadership roles in medium to large organizations leading projects of increasing size and complexity
- Demonstrated knowledge and hands-on experience in managing project scope, developing project schedules and budgets, managing risks and ensuring project quality
- Knowledge of healthcare billing requirements, Medicare/Medicaid rules, and basic insurance understanding
- Strong leadership skills with a demonstrated ability to inspire and produce results
- People management skills setting high standards for individual and technical performance
- Proven track record for leading process improvement initiatives and contributing to business solutions service orientation
- Proven analytical, technical and auditing skills
- Excellent written, oral and presentation skills
- Strong C-Suite presence and client management skills
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