Senior Supervisor, Quality Review and Audit

Senior Supervisor, Quality Review and Audit

Senior Supervisor, Quality Review and Audit

Job Overview

Location
Nyack, New York
Job Type
Full Time Job
Job ID
45424
Date Posted
3 months ago
Recruiter
Julia Hart
Job Views
180

Job Description

Reporting to the Pharmacy Manager, Fraud Waste & Abuse (FWA), the successful candidate will be responsible for leading the FWA team, some who live in other provinces or work from home. The FWA Pharmacy Supervisor will ensure that client commitments and required service standards are met through the daily supervision, coaching, and feedback to all team members.  The supervisor provides leadership in the following areas: Teamwork, Operational excellence, Performance Management, Customer Service and Innovation. This role directly contributes to building a higher performance culture and living The Express Way.

ESSENTIAL FUNCTIONS:

  • Lead the pharmacy audit team

  • Provide coaching, training and oversight of the department to ensure high quality service that will meet both internal and external needs

  • Identify, recommend and develop strategic initiatives to improve quality, and streamline and enhance operations so the team can detect and address risk in a timely manner

  • Support the design, building and testing of business applications and oversee implementation to ensure quality systems produce and maintain the desired results

  • Ensure standardization of practice throughout the team, while ensuring proper workflow and process management

  • Ensure that systems, procedures and personnel are available to efficiently provide audit services to meet our customer expectations and departmental objectives

  • Ensure client commitments are met, and present audit findings and recommendations to internal and external customers

  • Communicate effectively with internal and external stakeholders based on the needs of the business

  • Schedule and track all day-to-day audit activities of the team and monitor audit findings to ensure effective resolution

  • Streamline the production of department reports as required and distribute to appropriate personnel and clients

  • Review customer reporting and billing to identify accurate capture of revenues, evaluation of recoveries and generation of insights for adapting audit practices

  • Ensure the timely resolution of internal and external escalations

  • Support the team in their development - create and maintain a high functioning team while recommending career advancement opportunities

  • Resolve employee issues and disputes using effective conflict resolution strategies, including direct communication between the parties involved so they can come to a mutually acceptable resolution

  • Develop problem solving capabilities within the team to empower them and elevate team performance

QUALIFICATIONS:

  • 5+ years of experience in a hospital, community pharmacy setting, or experience in group benefits including pharmacy benefits

  • Governance, regulatory and/or audit experience required

  • Knowledge of provincial and federal pharmacy regulations and legislative requirements

  • Prior managerial experience an asset

  • Ability to coach/train, motivate, give and receive feedback in a constructive manner

  • Ability to people manage and develop talent

  • Demonstrated interpersonal skills to facilitate change management

  • Team player and ability to work cross-functionally with other departments

  • Excellent time and resource management skills

  • Self-driven, curious, ability to work independently with minimal supervision

  • Proven ability to manage competing priorities in a fast-based environment

  • Strong focus on quality and accuracy

  • Strong focus on customer service and presentation skills

  • Detail-oriented with proven high-level oral and written communication skills

  • Demonstrates and applies integrity in all aspects of work

  • Knowledge of Microsoft Office software (Word, Excel and PowerPoint)

  • Job requires precise finger/hand movements while working with a keyboard

  • Ability to work in an open work station environment

  • Need to remain at work station for lengthy periods

  • Ability to travel to quarterly and annual client meetings

Note: Internal employees should apply before December 30, 2021

Express Scripts Canada is a Cigna company

Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.

About Express Scripts Canada

Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment. We provide Active Pharmacyâ„¢ services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.

It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.

We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.

We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.

We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.

If you require accommodation in completing the online application process, please email: eschr2@express-scripts.com Do not email eschr2@express-scripts.com for an update on your application or to provide your resume as you will not receive a response.

Job ID: 45424

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