Lead Pharmacy Audit Consultant - Hybrid, High-Impact

Mercer; New York (NY); Hybrid; USD 103,000 - 205,000; Full time

Benefits offered by this job

Health benefits

Tuition assistance

401K retirement plans

Employee assistance programs

Job summary

Mercer is seeking a Pharmacy Audit Lead Consultant to join the Health & Benefits team. This hybrid role requires in-office presence at least three days per week and can be based near any US Mercer office.

You will lead end-to-end pharmacy claims and rebate audits for high-visibility clients, translating contracts into audit scope and supervising the team through final reports. You will mentor staff, partner with internal consultants, and drive innovations in audit methodologies while

Qualifications

• Bachelor's degree in pharmacy, healthcare, business, analytics, or related field.
• Minimum of 8 years of experience in pharmacy claims auditing, PBM operations, pharmacy benefit consulting, or health plan administration.
• Excellent knowledge of pharmacy benefits, claims adjudication, formulary administration, and specialty pharmacy.
• Strong knowledge of PBM contract terms, pricing methodologies, and pharmacy rebate structures.
• Client-facing experience in a consulting environment with internal collaborators.

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 and defensible sample selection.
• 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.

Skills

Pharmacy audit

PBM contracts

Data analysis

Client facing

Leadership

AI tools

Education

Bachelor's degree in pharmacy

PharmD

MBA

CPA

Tools

Analytics SaaS tools

Job description

Mercer is seeking a Pharmacy Audit Lead Consultant to join the Health & Benefits team. This hybrid role requires in-office presence at least three days per week and can be based near any US Mercer office.

You will lead end-to-end pharmacy claims and rebate audits for high-visibility clients, translating contracts into audit scope and supervising the team through final reports. You will mentor staff, partner with internal consultants, and drive innovations in audit methodologies while