Director of Audit - Synergie (Remote)

001_BCBSA Blue Cross and Blue Shield Association

Chicago, IL(remote)

JOB DETAILS
SALARY
$150,000–$200,000 Per Year
SKILLS
Analysis Skills, Auditing, Billing, Biotech and Pharmaceutical, Budgeting, Business Processes, Business Strategy, Communication Skills, Compensation and Benefits, Continuous Improvement, Corrective Action, Cross-Functional, Customer Service Management, Data Management, External Audit, Finance, Financial Operations, Health Plan, Healthcare, Leadership, Legal, Managed Care, Pharmacy, Policy Evaluation, Policy Implementation, Process Management, Regulatory Requirements, Risk, Risk Analysis, Risk Management, Risk Management Framework (RMF), Strategic Planning, Team Lead/Manager, Thought Leadership, Time Management, Vendor/Supplier Management
LOCATION
Chicago, IL
POSTED
1 day ago

About the Role The Director of Audit is responsible for overseeing the organization's client and pharmaceutical rebate audit function and ensuring the effectiveness of financial, operational, and contractual compliance controls across the enterprise. This role also supports organizational SOC audits. This role leads the planning and execution of audit programs, identifies risk exposures, and provides actionable recommendations to enhance operational execution, governance, efficiency, and compliance. The Director works closely with executive leadership to promote a strong internal control culture and continuous improvement mindset. In addition, this role supports participants in Synergie pharma audits.Audit Execution 35% Lead and oversee pharma and client audits for Synergie.Support SOC audit evidence gathering for annual audit.Ensure audit work adheres to contractual standards and organizational policies.Evaluate the efficiency and effectiveness of internal controls, processes, and risk management frameworks.Coordinate with external auditors and participants to ensure alignment and minimize redundancy.Communicate with participants during pharma rebate audits and obtain evidence requested.Risk Management and Compliance 35% Collaborate with Finance, Legal, and IT to strengthen controls around invoicing.Monitor corrective action plans, ensuring timely resolution of audit findings.Advise on new business processes, system implementations, and policy changes from a risk perspective.Assist in development and management of invoicing and audit policies and procedures.Leadership and Strategy 30% Develop and execute the annual risk-based audit plan aligned with organizational strategy and regulatory requirements.Provide strategic direction and thought leadership for audit, risk management, and internal control programs.Partner with internal leaders to identify and mitigate emerging risks within invoicing and data governance of invoicing information.Present findings, insights, and progress updates to Invoicing & Audit management.Qualifications Bachelor's degree in business, healthcare, or other related field; Master's degree preferred.8+ years of work experience in a health care auditing role, with expertise in health plans, health systems, pharmacy, and managed care or specialty pharmacy.At least 3 years of experience in medical and/or pharmacy drug management at a health plan or PBM.Strong experience managing external audit vendors during audits.Strong understanding of audit practices.Experience designing and executing audit programs.Strong data management and analytics skills with the ability to manage large data effectively.Strong knowledge of medical and pharmacy rebates, value-based contracts, and invoicing processes.Demonstrated ability to lead cross-functional teams, drive results in a fast-paced environment, and manage client support while ensuring alignment with Synergie's objectives.Ability to develop relationships and influence with internal and external stakeholders.Excellent leadership, communication, and critical thinking skills and ability to anticipate issues and develop solutions.Eligibility to work in the United States without need for work visa or residency sponsorship.Compensation and Benefits The compensation for this role is budgeted between $150,000 and $200,000. This position is remote. The employee may be eligible for an annual bonus incentive pay. Benefits include paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, and a lifestyle spending account.#J-18808-Ljbffr

About the Company

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001_BCBSA Blue Cross and Blue Shield Association

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.
COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Insurance
WEBSITE
https://www.bcbs.com/about-us/careers