Consultant, Audits - Pharmacy Benefits Audits and Analytics - Remote

Segal; Chicago (IL); Hybrid; USD 110,000 - 130,000; Full time

Job summary

A leading consulting firm seeks a Lead Pharmacy Claims Audit Consultant to provide strategic consulting and lead projects for clients. With a focus on employee well-being and a supportive work environment, the role offers significant career growth opportunities and flexible remote work options. Candidates should have extensive experience in pharmacy claims administration and data analysis skills for a competitive salary.

Benefits

Comprehensive benefits package

Flexible remote work options

Supportive work environment

Leadership opportunities

Qualifications

• 8+ years of pharmacy claims administration and/or audit experience required.
• Expertise in electronic audit functions.
• Proficiency in data analysis, particularly with SQL and Excel macros.

Responsibilities

• Serve as the lead pharmacy claims audit consultant for clients.
• Conduct technical analyses and quality reviews ensuring data integrity.
• Manage projects to meet defined scope, profitability, and productivity targets.

Skills

Data Analysis

Project Management

Client Relationship Management

Interpersonal Skills

Problem Solving

Education

Undergraduate Degree

Advanced Degree

Tools

SQL

Excel Macros

Microsoft Office Suite

Python

Job description

Employer Industry: Employee Benefits Consulting

Why consider this job opportunity:
- Salary up to $130,000 plus discretionary performance bonus based on company profitability and employee performance
- Comprehensive benefits package including a non-contributory defined benefit pension plan, 401(k) profit sharing plan, and health savings account contributions
- Opportunity for career advancement and growth within a leading consulting firm
- Flexible remote work options available
- Supportive work environment with a focus on employee well-being and professional development

What to Expect (Job Responsibilities):
- Serve as the lead pharmacy claims audit consultant for clients, providing strategic consulting on claims auditing practices
- Conduct technical analyses and quality reviews, ensuring data integrity and delivering actionable recommendations to clients
- Lead business growth strategies and marketing initiatives to support business development and cross-selling efforts
- Manage projects to meet defined scope, profitability, and productivity targets
- Respond to Requests for Proposals (RFPs) by preparing written proposals and defining project scope recommendations

What is Required (Qualifications):
- 8+ years of pharmacy claims administration and/or audit experience, including expertise in electronic audit functions
- Undergraduate degree; advanced degree preferred
- Proficiency in data analysis, particularly with SQL and Excel macros; knowledge of Python is a plus
- Strong project management and client relationship management skills
- Excellent interpersonal skills with the ability to build rapport with diverse audiences

How to Stand Out (Preferred Qualifications):
- Experience leading efforts to achieve revenue and/or profitability-oriented objectives
- Strong proficiency in Microsoft Office suite, including Word, Excel, PowerPoint, and Outlook
- Effective written and oral presentation skills, with a problem-solving mindset

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