Blue Cross Blue Shield Association logo
Blue Cross Blue Shield Association

For the Health of America

Director of Audit

DirectorDirectorFull TimeRemoteLeadTeam 1,001-5,000Since 1960H1B No SponsorCompany SiteLinkedIn

Location

Illinois + 3 moreAll locations: Illinois | Nebraska | Oregon | Virginia

Posted

59 days ago

Salary

$150K - $200K / year

Seniority

Lead

Bachelor Degree8 yrs expEnglish

Job Description

Director of Audit

Blue Cross Blue Shield Association

• Overseeing the organization’s client and pharmaceutical rebate audit function and ensuring the effectiveness of financial, operational, and contractual compliance controls across the enterprise. • Leading the planning and execution of audit programs, identifying risk exposures, and providing actionable recommendations to enhance operational execution, governance, efficiency, and compliance. • Closely working with executive leadership to promote a strong internal control culture and continuous improvement mindset. • Leading and overseeing pharma and client audits for Synergie. • Supporting SOC audit evidence gathering for annual audit. • Evaluating the efficiency and effectiveness of internal controls, processes, and risk management frameworks. • Monitoring corrective action plans, ensuring timely resolution of audit findings. • Developing and executing the annual risk-based audit plan aligned with organizational strategy and regulatory requirements.

Job 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.

Benefits

  • paid time off
  • 11 holidays
  • medical/dental/vision insurance
  • generous 401(k) matching
  • lifestyle spending account

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