Consultant, Audits - Pharmacy Benefits Audits and Analytics - Remote

The Segal Company (Midwest), Inc. in; Chicago (IL); Remote; USD 101,000 - 130,000; Full time

Job summary

A prestigious consulting firm is seeking a Consultant specializing in Pharmacy Benefits Audits to lead claims audits and provide strategic consulting services. Ideal candidates will have over 8 years of experience in pharmacy audits and strong data analysis expertise. Segal offers a competitive pay package with extensive benefits including retirement plans and professional development opportunities.

Benefits

Comprehensive suite of benefits

401(k) matching contributions

Paid time off including holidays and sabbaticals

Employee Assistance Program

Qualifications

• 8+ years of pharmacy claims administration and/ or audit experience is required.
• Experience with electronic audit functions and leading revenue-oriented objectives.
• Proficiency in relationship building and effective communication.

Responsibilities

• Lead pharmacy benefits claims audits and analysis for clients.
• Provide strategic consulting advice on auditing practices.
• Manage projects within profitability and productivity targets.

Skills

Data analysis

Interpersonal skills

Project management

Client servicing

Education

Undergraduate degree

Advanced degree preferred

Tools

SQL

Excel macros

Microsoft suite (Word, PowerPoint, Outlook)

Python

Job description

Consultant, Audits - Pharmacy Benefits Audits and Analytics - Remote (Finance)

Consultant, Audits - Pharmacy Benefits Audits and Analytics - Remote (Finance)

For nearly 80 years, Segal has been providing employee benefits, retirement plan investment advisory and human resources consulting for multiemployer trust funds, corporations and public sector organizations. Segal is an independent, privately and employee-owned firm. Our independence allows us to provide unbiased consulting services for our clients. Headquartered in New York City, Segal has offices throughout the United States and in Canada. We are a smaller organization that provides a more intense and broader exposure for development purposes within a culture that is highly collegial and team-oriented. You will work with colleagues who are smart, professional, talented and...nice people. We offer a competitive pay and benefits package that includes a defined benefit and matching 401(k) retirement plans.

Are you passionate about delivering trusted advice that improves lives?

Come work with us!

Our Consultant, Pharmacy Benefit Claims Audits and Analytics has responsibility for leading pharmacy benefits claims audits and analyses for our clients.

Key Responsibilities:

• Perform as the lead pharmacy claims audit consultant for clients.
• Provide strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.
• Conduct technical analyses and quality reviews and be passionate about the integrity of the data. Formulate conclusions and deliver client recommendations.
• Lead business growth strategies and marketing initiatives to assist business development and cross-selling efforts.
• Build and maintain effective rapport internally and with senior management in client organizations and internally within the company.
• Manage projects within scope, profitability and productivity targets.
• Respond to Requests for Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.
• Gather, use and share market intelligence to develop and introduce unique and/or new approaches to servicing our clients.

• 8+ years of pharmacy claims administration and/or audit experience to include significant exposure to and expertise in electronic audit functions to include systems and tools relevant to an independent/third-party audit process; experience leading efforts to achieve revenue and/or profitability-oriented objectives; actuarial experience valued.
• Undergraduate degree. Advanced degree preferred.
• Data analysis expertise to include familiarity with SQL and Excel macros highly preferred. Knowledge of Python is a plus.
• Project management and client servicing/relationship management skills.
• Effective interpersonal and relationship building skills with ability to build rapport with diverse audiences.
• Proficiency in writing and oral presentation and ability to problem solve, multi-task and manage multiple deadlines.
• Proficiency in Microsoft suite of products (i.e., Word, Excel, PowerPoint, and Outlook).

About Segal and its Total Rewards Program:
Segal is a privately owned, leading North American employee benefit, human resources, and investment management consulting firm with over 80 years of history providing trusted advice that improves lives. Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.
Segal's total rewards are part of what makes Segal a special place to work. The current salary range for this position is $101,500 to $130,000 plus opportunity for a discretionary performance bonus based on company profitability and employee performance. In addition, Segal offers a comprehensive suite of benefits to include a non-contributory defined benefit pension plan, matching and discretionary contributions to a 401(k) profit sharing plan, medical and prescription benefits including contributions to a health savings account for eligible employees, dental benefits, life insurance, disability insurance, an Employee Assistance Program, wellness benefit reimbursements and rewards, and professional credential and tuition reimbursement. Segal also provides comprehensive paid time off including holidays, vacation days, sick leave, paid family leave and sabbaticals.

Please Apply:
Segal is the right size, the right organization and…the right move for you! Please apply now.

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