At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
The Specialty Pharmacy Off-Phone Audit Manager leads the internal audit function for CVS Specialty’s off-phone and administrative operations. The manager will provide strategic leadership to a team of supervisors, and the team they support, of analysts, by setting clear expectations, fostering professional development, and ensuring accountability for performance outcomes aligned with organizational goals. This role oversees the planning, execution, and reporting of audits using Verint live monitoring and screen capture tools, ensuring compliance with regulatory standards, internal protocols, and driving continuous improvement in operational efficiency, patient safety, and service quality. It will be imperative that this leader possesses the skills to develop and implement the annual audit plan for pharmacy task functions including intake, benefits verification, order scheduling, prior authorization management, clinical reviews, as well as additional off-phone and administrative operations critical to specialty pharmacy services. This leader will ensure all pre-shipment issues are corrected to mitigate financial impact. This position requires strong leadership, analytical skills, and a deep understanding of auditing principles and pharmacy operations. This strategic role directly influences the key business decisions, drives increased productivity, and impacts the effectiveness and efficiencies within operations.
Required Qualifications
- 5+ years in internal audit, quality assurance, or pharmacy operations
- 5+ years in a leadership or management role with exempt & non-exempt direct reports
- Experience with Verint or similar live monitoring, screen capture audit platforms
- Experience in specialty pharmacy and payer-specific workflows
- Strong analytical skills with proficiency in data analysis tools and techniques
- Ability to process and synthesize quantitative and qualitative data to derive actionable solutions
- Data analysis skills, including the ability to wrangle and analyze large structured and unstructured datasets (Excel and more advanced analytical techniques)
- Engaging and driving business owners to address and resolve project risk or issues
- Power Point – Executive level presentations
- Understand business process improvement, project management and quality practices
- Excellent communication skills, with the ability to present data insights clearly to diverse audiences.
- As a SME around business and data driven projects; share and drive the offload of knowledge with team members
- Ability to be a mentor to less experienced Business Analyst and team members to drive compliance for best practices, methods, standards, and processes
- Ability to prioritize and meet deadlines with tight timeframes
Preferred Qualifications
- Six Sigma Certification
Education
High School Diploma or General Equivalent Development (GED)
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,300.00 - $159,120.00This 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.
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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 11/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Top Skills
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners.
Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
