Quality Review and Audit Advisor - Express Scripts - Remote

Job description

Quality Review and Audit Advisor The Quality Review and Audit Advisor provides expert execution for complex, high impact Quality Assurance and Audit initiatives. This role is responsible for planning, leading, and delivering largescale and cross-functional testing efforts that ensure accurate benefit, clinical, and pricing configuration while supporting successful client implementations and operational changes. Operating in a fast paced, highly collaborative environment, the Advisor exercises sound judgment, foresight, and creativity to develop testing strategies, evaluate issues, and drive resolution efforts that directly impact clients, members, providers, and vendor partners. The role partners closely with implementation, account management, operations, product, and regulatory teams—and works directly with clients as needed—to ensure thorough test planning, execution, validation, and clear communication of results. A core focus of the position is client centric benefit and clinical testing, validation of pricing and configuration accuracy, and deep understanding of client setup and operational processes. The Advisor supports regulatory and operational audits, contributes to proc...