Pharmacy Audit Engineer

Brown & Brown Insurance; Madison (WI); Presencial; USD 75 000 - 90 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health Benefits

Financial Benefits

Mental Health & Wellness

Beyond Benefits

Resumo da oferta

Brown & Brown / Remedy Analytics is seeking a full-time experienced Pharmacy Audit Engineer to join our Madison, WI team. You will lead pharmacy claims audits to verify PBM contract compliance, perform data loading and quality checks, and develop automated SQL workflows to deliver reliable insights.

You will collaborate with PBMs and the client support team, draft audit reports, and drive continuous improvements in audit procedures, controls, and analytics across multiple engagements.

Qualificações

• Bachelor’s degree in computer science, engineering and/or similar discipline with analytical bias.
• Highly proficient in database table creation/management, ETL process, complex Oracle/SQL queries, and code maintenance.
• Dimensional Model understanding and experience manipulating models, developing, and executing on business logic.
• Relevant experience that demonstrates problem-solving, financial acumen, and analytical output.
• Proficiency in MS Office applications (Excel, Word, Powerpoint, PowerBI etc.).
• Ability to thrive in a fast-paced environment, respond quickly to oversight, and develop efficiencies on repeat tasks.
• Excellent verbal and written communication skills to assemble data as applicable.
• Experience developing and maintaining effective, collaborative working relationships with clients and internal stakeholders.
• Strong sense of project ownership and the ability to manage high project volume effectively.
• Excellent problem-solving, critical thinking and analytics skills for cross-functional teams.
• Must be able to adapt to change in direction and priorities in a project- and deadline-oriented environment.

Responsabilidades

• Plan and develop the audit approach for assigned projects consistent with guidelines established by Remedy internal Audit Standards.
• Work simultaneously on multiple audits with differing deadlines while maintaining attention to detail within timelines.
• Analyze and perform quality checks of master files, profiles, and table changes to ensure changes are accounted for.
• Continuously improve audit automation transforms based on findings, industry changes, and tech updates.
• Track open audit observations and perform follow-up to evaluate remediation adequacy with PBMs and Remedy teams.
• Draft audit reports to effectively communicate results to Remedy account team.
• Perform daily/weekly ad hoc data analytics requests as prioritized by management.
• Re-evaluate system functionality to identify opportunities for improving operational efficiencies.
• Comply with regulatory areas, policies, and HIPAA requirements and leading practices.

Conhecimentos

Database design

ETL processes

Oracle/SQL queries

Code maintenance

Business logic

Analytical output

MS Office / PowerBI

Communication skills

Client/stakeholder relations

Project ownership

Problem solving / analytics

Adaptability

Formação académica

Bachelor’s degree in CS/Engineering

Ferramentas

PowerBI

Git / Bitbucket

Python (pandas/NumPy)

Visualization tools

Descrição da oferta de emprego

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brown / Remedy Analytics

is looking for a full-time experienced Pharmacy Audit Engineer , with keen analytical skills and an eye for detail, to join our growing team.

The Audit Engineer will be responsible for completing pharmacy claims audits to ensure compliance to PBM contracts. This role will involve facilitating calls with PBMs, obtaining claims audit data, perform data loading and data quality checks, data reconciliation, running and analyzing Oracle output reports, running ad-hoc analysis, reviewing PBM contracts, completing audit support documentation and working with the client support team to develop PBM & client deliverables. The audit engineer will utilize ad hoc SQL automation and build a highly customized framework to complete projects. This role will develop, prioritize, and conduct financial and operational audits to evaluate the effectiveness of PBM contracts, controls, and accuracy of financial information.

How You Will Contribute:

• Plan and develop the audit approach for assigned projects consistent with guidelines established by Remedy internal Audit Standards
• Work simultaneously on multiple audits with differing deadlines while maintaining attention to detail within the appropriate timelines
• Analyze and perform quality checks of master files, profiles, and table changes to ensure all changes are appropriately accounted for
• Continuously improve upon current audit automation transforms based on audit findings, industry changes, and technology updates
• Track open audit observations and perform follow-up to evaluate the adequacy of remediation efforts with both PBM and Remedy account team
• Draft audit reports to effectively communicate the results of the analysis to Remedy account team
• Perform (daily/weekly) ad hoc data analytics requests as prioritized per Department Management
• Re-evaluate system functionality to identify opportunities for improving operational efficiencies.
• Comply with and adhere to all regulatory compliance areas, policies, and procedures (including HIPAA requirements), and "leading practices".

Skills & Experience to be Successful:

• Bachelor’s degree in computer science, engineering and/or similar discipline with analytical bias
• Highly proficient in database table creation/management, ETL process, complex Oracle/SQL queries, and code maintenance
• Dimensional Model understanding and experience manipulating models, developing, and executing on business logic
• Relevant experience that demonstrates problem-solving, financial acumen, and analytical output
• Proficiency in MS Office applications (Excel, Word, Powerpoint, PowerBI etc.)
• Ability to thrive in a fast-paced environment, responding quickly to oversight and following instruction closely, while anticipating needs and developing efficiencies on repeat tasks
• Excellent verbal and written communication skills to assemble data as applicable
• Experience developing and maintaining effective, collaborative working relationships with clients and internal stakeholders
• Strong sense of project ownership and the ability to manage high project volume effectively
• Excellent problem-solving, critical thinking and analytics skills with the ability to work in a cross-functional team.
• Must be able to adapt to change in direction and priorities in a project and deadline-oriented environment.

Preferred but not required:

• Experience in Project Management
• Experience with version control (git, bitbucket)
• Familiarity with Visualization tools (PowerBI/SSRS preferred)
• Proficiency in Python (pandas, NumPy, general data manipulation techniques)
• Familiarity with low code to no code solutions
• Experience working with Pharmacy and/or Medical claims data
• Pharmacy claims audit experience &/or knowledge of pharmacy claims data

Pay Range$75,000 - $90,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.

Teammate Benefits & Total Well-Being

Health Benefits

Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance

Financial Benefits

ESPP; 401k; Student Loan Assistance; Tuition Reimbursement

Mental Health & Wellness

Free Mental Health & Enhanced Advocacy Services

Beyond Benefits

Paid Time Off, Holidays, Preferred Partner Discounts and more.Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

Recruiting Vendor Disclosure Statement

Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies ("Recruiting Vendors"). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions. Additional information regarding this policy can be found on our careers page.

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.