Pharma Risk & Fraud Analyst

QS/1 Data Systems; Spartanburg (SC); Hybrid; USD 95,000 - 115,000; Full time

Benefits offered by this job

Paid time off

Medical insurance

Dental insurance

Vision insurance

401(k) with 5% match

Fitness bonus

Professional development

Well-being programs

Job summary

RedSail is seeking a Business Analyst (RAS) in Spartanburg, SC to protect the integrity of its products, services, and customer ecosystem by monitoring account activity and analyzing operational data. You will review data from RAS/PowerLine and the Pharmacy Management System to identify patterns, support decisions, and recommend corrective actions, while handling sensitive information with discretion.

This hybrid role requires 3–5 years in pharmacy, strong analytical skills, and the ability to

Qualifications

• Bachelor’s degree in business, finance, healthcare administration, criminal justice, data analytics is required.
• 3–5 years of experience in the pharmacy industry is required.
• Experience with pharmacy workflows and systems is expected.

Responsibilities

• Review account activity when unusual or potentially non-compliant activity is identified, including researching anomalies, evaluating transactional patterns, and documenting findings.
• Conduct proactive reviews of randomly selected accounts to help ensure appropriate use of RedSail products and services and to identify emerging operational and business risks.
• Analyze and compare data from RAS/PowerLine and other internal systems to identify inconsistencies, unusual activity, and account integrity indicators.
• Review data directly within the PMS for specific cases to validate activity, confirm details, and support account reviews and investigations.
• Document account reviews, investigation outcomes, trends, and recommendations clearly and accurately for leadership and cross-functional partners.
• Collaborate with internal teams to escape findings, recommend corrective actions, strengthen internal controls, and support account integrity initiatives through investigation outcomes and policy recommendations.
• Lead assigned reviews and projects and ensure timely completion of routine and complex investigative assignments.

Skills

Pharmacy workflows

Data analysis

Investigative skills

Attention to detail

Communication skills

Education

Bachelor’s degree in business, finance, healthcare administration, criminal justice, data analytics

Tools

RAS/PowerLine

PMS platforms

Microsoft Office Suite

Job description

RedSail is seeking a Business Analyst (RAS) in Spartanburg, SC to protect the integrity of its products, services, and customer ecosystem by monitoring account activity and analyzing operational data. You will review data from RAS/PowerLine and the Pharmacy Management System to identify patterns, support decisions, and recommend corrective actions, while handling sensitive information with discretion.

This hybrid role requires 3–5 years in pharmacy, strong analytical skills, and the ability to