Pharmacy Audit Engineer

Brown & Brown Insurance; United States; Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Health Benefits

401k plan

Tuition Reimbursement

Job summary

Brown & Brown / Remedy Analytics is seeking a full-time Pharmacy Audit Engineer to join our growing team in the United States. The role requires keen analytical skills, attention to detail, and experience auditing pharmacy claims to ensure PBM contract compliance.

You will load and validate data, run Oracle/SQL reports, perform ad hoc analyses, and develop an automated framework for audits. Collaboration with PBMs and Remedy account teams is expected to deliver precise, actionable audit

Qualifications

• Bachelor’s degree in computer science, engineering or similar with analytical bias.
• Highly proficient in database table creation/management, ETL, complex Oracle/SQL queries, and code maintenance.
• Dimensional Model understanding and experience with business logic.
• Relevant experience demonstrating problem-solving, financial acumen, and analytical output.
• MS Office applications (Excel, Word, PowerPoint, PowerBI).

Responsibilities

• Plan and develop the audit approach for assigned projects per Remedy Audit Standards.
• Work on multiple audits with varying deadlines while maintaining detail and timely delivery.
• Analyze master files, profiles, and table changes; ensure changes are properly accounted for.
• Improve audit automation transformations based on findings and tech updates.
• Track open audit observations and follow up with PBMs and Remedy teams.
• Draft audit reports to communicate results effectively.
• Perform daily/weekly ad hoc data analytics as requested by management.
• Re-evaluate system functionality to identify efficiency improvements.

Skills

SQL queries

ETL processes

Data analysis

MS Office

Oracle

Education

Bachelor's degree in CS/Engineering

Tools

Oracle/SQL

PowerBI

Git/Bitbucket

Python

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

• 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.

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”.