Insight Global
Remote Prior Authorization Audit Specialist
Insight Global, Eden Prairie, Minnesota, United States, 55344
An employer is looking for a highly skilled remote Prior Authorization Audit Specialist to join one of our largest national healthcare clients for a contract through the end of the year. At this time, this role does not have the possibility to extend and is just approved for a shorter-term engagement. In this role you will join a growing team and work to complete audits or remediation from client requests. This will include researching PBM mandates needed from state and federal regulation to ensure we're in compliance. This also will include handling and heading up CMS or client audits, or other state or regulatory audits as needed. In this role you must be extremely detail orientated and comfortable with accurate documentation. You also must be comfortable reading and understanding regulations and responding to clients in a professional and concise manner, especially as it relates to regulation jargon.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal. com.
To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . -5 years of professional experience within the PBM Ops space -Ability to pivot as needed and prioritize State / Federal / Government related audits -Ability to read and understand State / CMS / Government regulations and respond professionally to clients and stakeholders -Collaborative and team oriented personality
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal. com.
To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . -5 years of professional experience within the PBM Ops space -Ability to pivot as needed and prioritize State / Federal / Government related audits -Ability to read and understand State / CMS / Government regulations and respond professionally to clients and stakeholders -Collaborative and team oriented personality