Product Management Senior Manager of Regulated Markets Audit - Express Scripts - Hybrid

Description of Position:


* The Product Management Senior Manager of Regulated Markets Audit is responsible for leading a team that serves as the Regulated Markets point of contact for Government Audits and the issue management of Regulated Markets book of business items.

This individual will serve as a point of contact for leadership within Regulated Markets and assist in setting the strategic direction to their team, other Regulated Market capability owners, and the broader organization in support of Regulated Market Government Audits.

The ideal candidate will have a broad based knowledge of Regulated Markets, experience leading people, a strategic mindset, the ability to influence and drive change, and skilled in project management.

This position will ensure compliance with the Center for Medicare and Medicaid Services (CMS) guidance/regulations, work cross functionally across the organization to ensure that individuals across the organization are prepared to support CMS audits, provide subject matter expertise to internal/external stakeholders, represent Express Scripts and our Clients in CMS program audits, and ensure that issues are addressed timely.

Position Details:


* Lead a team of Advisors and/or Senior Advisors that effectively support the management processes related to Regulated Market audits


* Work cross functionally across the PBM in support of Regulated Market Audits and serve as the point of contact for the Government Audit team


* Build and implement management processes in support of CMS program audits for both the Regulated Markets and the Health Plan divisions.

This includes the implementation of comprehensive training program, establishing related processes to manage internal / external policies


* Individual and team will be the capability advocate for Regulated Markets audits with all cross-functional areas of the organization


* Work across the Regulated Markets organization to track issues and bring them to resolution and closure.

This may entail working with Subject Matter Experts to create business justification for a business and/or IT project.


* Creates project scope, project plan, tracks project deliverables, and communicates project status


* Understand and use system tools to research and resolve issues and concerns


* Cross-train and support other team initiatives where appropriate

Qualifications:


* Bachelor's degree in related field or equivalent relevant experience in lieu of degree


* Regulated Markets experience preferred


* Familiarity with pharmacy adjudication and other PBM operations


* Experience in managing and implementing large scale initiatives preferred


* Strong strategic, analytical, problem solving, and project management skills required


* Successful track record as a people manager and/or possesses clear aptitude as a leader


* Excellent organizational agility skills with a strong understanding of business processes and op...