Remote Pharmacy Insurance Jobs in Alabama (NOW HIRING)

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 manage invoicing and audit policies and procedure.

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.

Requirements:

• 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. Must include 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.
• Must be eligible to work in the United States without need for work visa or residency sponsorship.

The compensation for this role is budgeted between $150,000 and $200,000.

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