Hybrid Pharmacy Audit Lead, Client-Facing Expert

Mercer; St. Louis (MO); Hybrid; USD 103,000 - 205,000; Full time

Benefits offered by this job

Hybrid work model

Anchor day in office

Job summary

Mercer is seeking a Pharmacy Audit Lead Consultant to join its Health & Benefits team. The role supports hybrid work with at least three in-office days weekly, and focuses on leading complex pharmacy claims and rebate audits from planning to final reporting.

Applicants should have 8+ years in pharmacy claims auditing or related areas, deep knowledge of PBM contracts, pricing, and rebate structures, and strong client-facing consulting experience. Bachelor's degree required.

Qualifications

• Bachelor's degree or higher in a relevant field.
• 8+ years of experience in pharmacy claims auditing or related areas.
• Strong knowledge of pharmacy benefits, claims adjudication, formulary administration, and specialty pharmacy.

Responsibilities

• Lead end-to-end pharmacy claims and rebate audits for complex, high-visibility clients.
• Translate PBM contracts, pricing guarantees, formulary terms, and rebate agreements into audit scope.
• Oversee claim and rebate review activity with consistent methodology and clear documentation.
• Quantify financial impact, evaluate vendor responses, and drive issues to resolution.
• Serve as primary client contact, presenting methodology, findings and recommendations.
• Mentor team members and help expand services and innovation in audit methods.

Skills

Pharmacy claims auditing

PBM operations

Pharmacy benefit consulting

Health plan administration

PBM contract terms

Pricing methodologies

Rebate structures

Client-facing experience

Education

Bachelor's degree in pharmacy, healthcare, business, finance, analytics, or related field

Advanced degree or credential (PharmD, RPh, MBA, CPA)

Job description

Mercer is seeking a Pharmacy Audit Lead Consultant to join its Health & Benefits team. The role supports hybrid work with at least three in-office days weekly, and focuses on leading complex pharmacy claims and rebate audits from planning to final reporting.

Applicants should have 8+ years in pharmacy claims auditing or related areas, deep knowledge of PBM contracts, pricing, and rebate structures, and strong client-facing consulting experience. Bachelor's degree required.