We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
CVS Health is seeking a dynamic and experienced professional to join our team in a Sr Manager role focused on Client Audit State-Initiated. The Sr Manager of Client Audit State-Initiated will lead a team of professionals responsible for coordinating, managing, tracking, reviewing, researching, and assisting with multiple complex financial audits initiated by Regulators or contracted third parties. In this position, the Sr. Manger will work closely with clients, governmental auditors, the client account team, legal, and many other internal departments to ensure the completion of requested audits with consistency and minimal disruption to the business.
As a Senior Manager, you will be responsible for the team’s timely and satisfactory resolution of exceptions identified during the audit process, specifically related to delegated PBM services. This position will also be expected to identify process enhancement opportunities to reduce or eliminate risk of future audit exceptions, as well as ensuring any concerns / issues are raised immediately to senior management. This client-facing position will also be responsible for leading and executing complex audits across all lines of business, including Commercial, Medicaid, and Exchange. In this role, you will bring a deep understanding of Pharmacy Benefit Manager (PBM) services, strong project management skills, and the ability to lead cross-functional teams in a fast-paced, high-stakes environment. Additional skills must include abilities to analytically identify, track and encourage business owners in process enhancement opportunities to reduce risks, as well as researching claim specific questions.
Key Responsibilities:
Work directly with the governmental auditors, the client and all the internal business areas involved in the audit
Manage the workload successfully as there is no room for error with government audits and these audits come in waves across many clients at the same time which the position needs to be able to juggle all the competing priorities
Analyze audit activities to evaluate performance of the organization and staff in meeting annual objectives
Have a deep knowledge base around Medicaid, Exchanges and Commercial lines of business
Relationship management skills: capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously
Work independently with limited direction from the Lead Director
Coordinate, manage, track the audits from start to closure
Work with the team to resolve any alleged issues, working strategically and achieving results
Work with the right business leaders to ensure responses are accurate and senior leaders are aware of any issues in accordance with regulatory timelines
Understand the intricacies of pharmacy services, to support the audit work with the auditors, answering their questions correctly and confidently
Identify process enhancements, as well as any gaps in controls within the business areas being audited
Raise the appropriate items to senior leaders and doing so timely
Documenting correspondence with internal partners, clients, and auditors
Tracking all audit progress to ensure that all deliverables are provided by due dates
Required Qualifications
7+ years of prior relevant experience in audit, project management, or financial advisory role
2+ years of leadership experience
3+ years of pharmacy claims experience
Proven ability to manage multiple priorities under tight deadlines with minimal supervision
Experience presenting to senior leadership
Ability to interact effectively with Government Auditors and Clients while under pressure during an audit is a must
Willingness to travel up to 10% (including plane)
Preferred Qualifications
Past Project Management experience is desired
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Visio)
PBM industry experience
7+ years pharmacy claim experience
Demonstrated ability to build and maintain relationships across all levels of an organization
Strong analytical, critical thinking, and problem-solving skills
Strong ability to maintain attention to detail and organizational skills
Strong tolerance for ambiguity and stress
Team building skills that effectively influence and engage others in issue resolution-demonstrates pro-activeness looking out for the success of the team and CVS Health
Solves complex problems; takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information
Excellent verbal and written communication skills
Education
BS/BA required; equivalent years of work experience may substitute
CPA, CIA or MBA preferred
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Similar Jobs
What you need to know about the Colorado Tech Scene
Key Facts About Colorado Tech
- Number of Tech Workers: 260,000; 8.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Lockheed Martin, Century Link, Comcast, BAE Systems, Level 3
- Key Industries: Software, artificial intelligence, aerospace, e-commerce, fintech, healthtech
- Funding Landscape: $4.9 billion in VC funding in 2024 (Pitchbook)
- Notable Investors: Access Venture Partners, Ridgeline Ventures, Techstars, Blackhorn Ventures
- Research Centers and Universities: Colorado School of Mines, University of Colorado Boulder, University of Denver, Colorado State University, Mesa Laboratory, Space Science Institute, National Center for Atmospheric Research, National Renewable Energy Laboratory, Gottlieb Institute

