Controlled Substance Monitoring Analyst II (Finance)
Support the company's Controlled Substance Compliance Program (CSCP) structure and foundation through monitoring and research of dispensing activities in company pharmacies. This position will work closely with the Controlled Substance Monitoring team and manager on process improvements, quality assurance protocols and reporting and analysis of trends to provide periodic feedback to stakeholders and other critical functions. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety.MINIMUM
- 4+ years healthcare, pharmacy, fraud prevention, risk management, audit, or compliance
- Thorough knowledge of controlled substance regulations and indicators of potential diversion of controlled substances in healthcare
- Ability to handle multiple projects and respond to changing business priorities
- Strong follow-up, accountability, and attention to detail
- Ability to analyze complex data and present effective reports
- Strong analytical, problem-solving, and organizational skills
- Experience using data analytics tools to identify trends and anomalies
- Proficient in Microsoft Word, PowerPoint and Excel with experience using Excel data analytics tools.
- Excellent oral/written communication
- Ability to manage multiple tasks, work independently and contribute to a collaborative team environment
DESIRED
- Bachelor's Degree
- Certified Fraud Examiner
- Execute transaction monitoring of assigned divisions to assess potential suspicious activity indicating diversion, abuse or fraud related to controlled substances
- Conduct detailed data analysis to identify trends, patterns and anomalies as they relate to controlled substance regulations and guidance for use in transaction monitoring and enhanced due diligence procedures and interventions
- Interpret data findings and prepare summaries and presentations to communicate insights to stakeholders
- Assist with the design and implementation of alert rules for use in transaction monitoring & conduct periodic review of alerts to ensure controls align to objectives
- Conduct investigations using all available systems to research suspicious activity and fraud and maintain case investigation documentation in accordance with department standards
- Perform periodic and for-cause pharmacy and prescriber risk analysis of assigned divisions and develop reporting for management to communicate findings
- Support the development and implementation of risk assessment tools and methodologies to mitigate compliance issues.
- Manage data processing workflows and contribute to the optimization of data management practices
- Develop and maintain case investigation documentation processes and quality assurance protocols to ensure accurate documentation
- Provide direction to other controlled substance Analysts on processes, procedures, and application of policy requirements
- Assist manager with identifying process improvements and complete special projects as assigned by manager
- Report high risk activity to manager in a timely manner
- Adhere to Kroger policies and procedures and comply with all applicable federal and state laws, regulations and guidance as they relate to controlled substances
- Travel up to 10% to meet with internal clients and vendors; attend industry training programs to maintain expertise in current or future subject matter areas as approved by manager
- Ability to work cooperatively in high paced and sometimes stressful environment
- Ability to manage conflict in a reasonable, nonconfrontational and cooperative manner
- Ability to act with honesty and integrity regarding customer and business information
- Ability to follow directions and seek assistance when necessary to resolve customer and business issues
- Provide support and assistance through direct interaction with minors, individuals with special needs, and/or older adults
- Must be able to perform the essential functions of this position with or without reasonable accommodation
