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Remote Internal Audit Risk Management Jobs in Missouri

Deloitte

Manager - ServiceNow

Kansas City, MO · On-site +1

... Risk Management workstreams in partnership with architects and product owners * Managing ... This compensation range is specific to Remote role and takes into account the wide range of factors ...

USA Mortgage

Secondary Marketing Analyst

Creve Coeur, MO · On-site +1

$80K - $100K/yr

Remote POSITION SUMMARY DESCRIPTION The Secondary Marketing Analyst supports the Capital Markets ... Hedge and pipeline risk management. * Pricing strategies and best execution. * Loan sale and ...

New

Sprinto

... compliance, audits, risk management, vendor risk, privacy, and AI governance, enabling ... Being remote means we rely less on proximity and more on trust. We write things down, communicate ...

Manulife

Advanced Markets Consultant

Louisiana, MO · On-site +1

... risk management for complex planning concepts and sales strategies. As a member of the Advanced ... This opportunity is a remote role and can be based anywhere in the US. Key Accountabilities:

Jobgether

Help establish risk management frameworks, compliance roadmaps, and vendor risk management ... Remote-first working environment with the flexibility to work from Poland. * Opportunity to advise ...

Cigna

Global Travel Specialist - Hybrid

Saint Louis, MO · Remote

... Compliance, Risk Management, and Internal Travel teams to resolve issues and strengthen travel ... Manage reporting, reconciliations, financial audits, and travel program analytics to ensure data ...

Jobgether

... internal and external teams. * Advise customers on fraud, payments, compliance, and risk-management ... Remote-first flexibility with the ability to work from home or another productive location.

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Remote Internal Audit Risk Management information

What is the difference between Remote Internal Audit Risk Management vs Remote Compliance Analyst?

AspectRemote Internal Audit Risk ManagementRemote Compliance Analyst
CertificationsCPA, CIA, CISACCA, CRCM
Work EnvironmentAudit departments, risk management teamsRegulatory compliance departments, legal teams
Industry UsageFinance, banking, insuranceFinancial services, healthcare, banking
Primary FocusAssessing internal controls, risk mitigationEnsuring adherence to regulations, policies

Remote Internal Audit Risk Management professionals focus on evaluating internal controls and mitigating risks within organizations, often working closely with audit teams. In contrast, Remote Compliance Analysts concentrate on ensuring organizations adhere to legal and regulatory requirements. While both roles require understanding of industry standards and certifications, their core responsibilities differ, with internal audit emphasizing risk assessment and compliance analysis focusing on regulatory adherence.

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Cities in Missouri with the most Remote Internal Audit Risk Management job openings:

Remote Internal Audit Risk Management jobs near you

Pharmacy Claims Audit Supervisor - Remote US

Gainwell Technologies

MO • Remote

$47K - $67K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 13 days ago

Gainwell Technologies rating

7.9

Company rating: 7.9 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

130th of 247 rated software companies

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

Supervises claims audit operations within Pharmacy Benefit Management (PBM) services. Ensures accurate adjudication of pharmacy claims while maintaining compliance with Medicaid requirements and operational performance standards.  The Claims Audit Supervisor will have oversight of all FWA Audit Services including Concurrent Claims Review, Desk Audit and Field Audit.

Your role in our mission
  • Lead and develop a team responsible for drug claims auditing and adjudication activities
  • Oversee claim audit workflows to ensure accuracy, timeliness, and compliance with PBM and Medicaid guidelines
  • Monitor performance metrics (productivity, quality, turnaround times) and implement process improvements to identify discrepancies.
  • Manage escalations and resolve complex claims issues involving members, providers, and pharmacies
  • Partner with internal teams to support system updates, audits, and ongoing claims operations
  • Work with state to present audit findings, develop new capabilities and manage appeal processes
What we're looking for
  • Must hold an active Pharmacy Technician certificatioin (CPhT), such as PTCB.
  • 5+ years of PBM, pharmacy operations, drug claims processing and audit operations experience
  • 2+ years of leadership or supervisory experience
  • Strong knowledge of identifying drug claim anomalies and pharmacy audit operations
  • Strong knowledge of pharmacy claims adjudication and Medicaid programs
  • Experience with client communications and leading discussions with clients
  • Experience with operational reporting, KPIs, and process improvement
What you should expect in this role
  • This is a remote work from home position.
  • Leadership within a high-volume audit processing environment
  • Collaboration with pharmacy, clinical, clients and IT teams
  • Focus on accuracy, compliance, and operational efficiency
  • Access to Gainwell's competitive benefits package for eligible employees, including medical, dental, vision, and 401(k) options in accordance with applicable eligibility guidelines.

#LI-REMOTE

#LI-JT1

#LI-CM1

The pay range for this position is $47,300.00 - $67,600.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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