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[Remote] Director of Audit - Synergie (Remote)
Note: The job is a remote job and is open to candidates in USA. Blue Cross Blue Shield Association is seeking a Director of Audit to oversee the client and pharmaceutical rebate audit function. This role involves leading audit programs, ensuring compliance, and collaborating with executive leadership to promote a strong internal control culture.
Responsibilities
- 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
- 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
- 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
Skills
- Bachelor's degree in business, healthcare, or other related field
- 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
- Must be eligible to work in the United States without need for work visa or residency sponsorship
- Master's degree
Benefits
- Annual bonus incentive pay
- Paid time off
- 11 holidays
- Medical/dental/vision insurance
- Generous 401(k) matching
- Lifestyle spending account
- Many other benefits
Company Overview