Audit Manager

Develop, maintain, and execute TrueScripts’ comprehensive audit program.

Establish an annual audit calendar incorporating regulatory, client, vendor, internal, and other required audits.

Serve as the primary coordinator and point of contact for audits from initiation through final resolution.

Develop audit plans, timelines, evidence requests, testing approaches, and deliverables.

Maintain centralized documentation of audit requirements, evidence, findings, responses, and remediation activities.

Monitor audit deadlines and proactively identify potential risks to successful completion.

Establish consistent audit processes, standards, templates, and controls across the organization.

Coordinate and manage regulatory and healthcare-related audits, including Market Conduct Audits and other applicable state and federal examinations.

Partner with Compliance and Legal to interpret audit requirements and ensure appropriate organizational responses.

Monitor regulatory changes that may create new audit requirements or areas of risk.

Coordinate client audits and information requests while ensuring responses are accurate, complete, timely, and appropriately documented.

Partner with Client Services and other business leaders to understand contractual audit requirements.

Establish standardized processes for responding to client audit requests.

Review audit responses and supporting documentation for completeness and consistency.

Identify opportunities to reduce the operational burden associated with recurring client audits.

Evaluate the effectiveness of existing controls and develop and execute internal audits based on organizational risk, regulatory requirements, operational performance, and emerging concerns.

Conduct process reviews and control assessments across business functions.

Partner with process owners to develop practical corrective actions.

Own the centralized tracking of audit findings and corrective action plans.

Partner with leaders to establish root causes, corrective actions, owners, and target completion dates.

Monitor remediation progress and escalate overdue or high-risk items and validate implementation of corrective actions.

Provide leadership with visibility into outstanding risks and remediation efforts.

Develop a strong understanding of claims administration, adjudication, pharmacy benefit processes, and related operational controls and partner with internal stakeholders to obtain and validate audit evidence.

Support audits involving claims configuration, adjudication, pricing, eligibility, benefits, reporting, prior authorization, pharmacy networks, and other PBM functions.

Identify opportunities to automate recurring audit activities and reduce manual effort.

Develop audit readiness checklists and documentation standards for key business processes.

Evaluate opportunities to automate evidence collection, testing, reporting, and audit tracking and improve audit workflows

Partner with Technology and Business Transformation teams to improve audit workflows and reporting.

This role is a remote job with a flexible “8-5” 40 to 45-hour workweek. All employees of TrueScripts must understand and adhere to Confidentiality and Personal Health Information (PHI) Guidelines as stated in the Employee Handbook.

While performing the duties of this job, the employee is frequently required to sit, use hands and fingers and to type for up to eight hours in a workday.