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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
Blue Cross Blue Shield Association is a national federation of 36 independent operated Blue Cross and Blue Shield companies. It was founded in 1929, and is headquartered in Chicago, Illinois, USA, with a workforce of 1001-5000 employees. Its website is
