Pharmacy Audit Engineer

Brown & Brown, Inc.; Town of Grand Rapids (WI); On-site; USD 75,000 - 90,000; Full time

Benefits offered by this job

Health benefits

401k

Paid time off

Dental and Vision insurance

Job summary

Brown & Brown / Remedy Analytics is seeking a full-time experienced Pharmacy Audit Engineer to join our growing team in a data-driven audit role. You will lead pharmacy claims audits, collect data, perform loading and quality checks, and create client-ready deliverables using SQL and Oracle reports.

The role emphasizes developing automated audit solutions, reviewing PBM contracts, and delivering analytics to support remediation and client success.

Qualifications

• 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.

Responsibilities

• 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

Analytical skills

Attention to detail

Communication skills

Problem-solving

Fast-paced environment

Education

Bachelor's degree in computer science/engineering

Tools

Oracle/SQL

PowerBI

Python (pandas, NumPy)

Git/Bitbucket

Job description

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

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

• 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.

The Power To Be Yourself

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".