The ideal consultant will have experience auditing PBMs, health plans, insurers, or third-party administrators, with a strong understanding of drug pricing, rebates, and claims adjustments.
Required Skills:
Have knowledge of Generally Accepted Accounting Principles (GAAP) and Statements of Statutory Accounting principles (SSAP).
Research and consistently apply state laws, department regulations, National Association of Insurance Commissioners (NAIC) statutory accounting practices, and Federal Deposit Insurance Corporation (FDIC) regulations and practices.
Knowledge of exam planning procedures, internal controls, sampling techniques, testing procedures, work paper preparation / documentation -Review procedures and report writing.
Knowledge of financial analysis techniques and ratios.
Understand and evaluate enterprise risk management, functions of insurers and pharmacy benefit managers....