Pharmacy Audit Engineer

Brown & Brown; Wisconsin; On-site; USD 75,000 - 90,000; Full time

Job summary

Brown & Brown Remedy Analytics seeks a full-time Pharmacy Audit Engineer to lead pharmacy claims audits, ensure PBM contract compliance, and build automated SQL-driven workflows.

You will analyze Oracle outputs, perform data quality checks, draft audit reports, and collaborate with the client support team to deliver PBM & client deliverables while adhering to HIPAA and regulatory guidelines.

Qualifications

• Bachelor’s degree in CS/engineering or similar with analytical bias.
• Strong SQL/ETL, Oracle experience, and data quality skills.
• Experience with Power BI, Excel, and data visualization.
• Strong communication and cross-functional collaboration.

Responsibilities

• Plan and develop audit approaches for projects per internal standards.
• Manage multiple audits with tight deadlines and high detail.
• Quality-check master files, profiles, and table changes.
• Improve audit automation transforms based on findings.
• Track audit observations and follow up with PBMs and clients.
• Draft audit reports communicating results to the team.

Skills

SQL queries

ETL processes

Dimensional modeling

Python

Power BI

Git

Data analysis

Communication

Education

Bachelor's degree in CS/Engineering or similar

Tools

Power BI/SSRS

Git/Bitbucket

Python (pandas, NumPy)

Low-code/no-code tools

Visualization tools

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:o Plan and develop the audit approach for assigned projects consistent with guidelines established by Remedy internal Audit Standardso Work simultaneously on multiple audits with differing deadlines while maintaining attention to detail within the appropriate timelineso Analyze and perform quality checks of master files, profiles, and table changes to ensure all changes are appropriately accounted foro Continuously improve upon current audit automation transforms based on audit findings, industry changes, and technology updateso Track open audit observations and perform follow-up to evaluate the adequacy of remediation efforts with both PBM and Remedy account teamo Draft audit reports to effectively communicate the results of the analysis to Remedy account teamo Perform (daily/weekly) ad hoc data analytics requests as prioritized per Department Managemento Re-evaluate system functionality to identify opportunities for improving operational efficiencies.o Comply with and adhere to all regulatory compliance areas, policies, and procedures (including HIPAA requirements), and \"leading practices\".Skills & Experience to be Successful:o Bachelor’s degree in computer science, engineering and/or similar discipline with analytical biaso Highly proficient in database table creation/management, ETL process, complex Oracle/SQL queries, and code maintenanceo Dimensional Model understanding and experience manipulating models, developing, and executing on business logico Relevant experience that demonstrates problem-solving, financial acumen, and analytical outputo Proficiency in MS Office applications (Excel, Word, Powerpoint, PowerBI etc.)o Ability to thrive in a fast-paced environment, responding quickly to oversight and following instruction closely, while anticipating needs and developing efficiencies on repeat taskso Excellent verbal and written communication skills to assemble data as applicableo Experience developing and maintaining effective, collaborative working relationships with clients and internal stakeholderso Strong sense of project ownership and the ability to manage high project volume effectivelyo Excellent problem-solving, critical thinking and analytics skills with the ability to work in a cross-functional team.o Must be able to adapt to change in direction and priorities in a project and deadline-oriented environment.Preferred but not requiredo Experience in Project Managemento Experience with version control (git, bitbucket)o Familiarity with Visualization tools (PowerBI/SSRS preferred)o Proficiency in Python (pandas, NumPy, general data manipulation techniques)o Familiarity with low code to no code solutionso Experience working with Pharmacy and/or Medical claims datao Pharmacy claims audit experience &/or knowledge of pharmacy claims dataPay Range$75,000 - $90,000 AnnualThe 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-BeingWe go beyond standard benefits, focusing on the total well-being of our teammates, including:Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability InsuranceFinancial Benefits: ESPP; 401k; Student Loan Assistance; Tuition ReimbursementMental Health & Wellness: Free Mental Health & Enhanced Advocacy ServicesBeyond 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 StatementBrown & 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 YourselfAs 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”.