Pharmacy Audit Engineer Analyst

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

Benefits offered by this job

Health Benefits

401k Plan

Tuition Reimbursement

Paid Time Off

Job summary

Brown & Brown Remedy Analytics is seeking a full-time Pharmacy Audit Engineer/Analyst to conduct pharmacy claims audits ensuring PBM contract compliance. The role involves data loading, quality checks, and ad-hoc analysis using SQL automation within a regulated environment.

Strong communication with PBMs and the Remedy team is essential. The ideal candidate has experience with SQL, Oracle, Power BI, and data visualization, with a bachelor’s degree in data science or analytics, and an ability to

Qualifications

• Bachelor’s degree in data science, or analytics or similar discipline.
• Experience with data audits/analytics for healthcare or PBM contracts is a plus.
• Proficiency with SQL and data quality checks is essential.

Responsibilities

• Plan and develop the audit approach per Remedy Audit Standards.
• Coordinate multiple audits with deadlines and maintain accuracy.
• Analyze master files, profiles, and table changes for accuracy.
• Improve audit automation transforms based on findings and tech changes.
• Track observations and follow up on remediation with PBM and Remedy teams.
• Draft audit reports communicating results to the account team.
• Perform ad hoc data analytics requests as prioritized.
• Re-evaluate systems to find efficiencies in operations.

Skills

SQL

Oracle

Window functions

Data loading

Power BI

Excel

Communication

Problem-solving

Cross-functional

Education

Bachelor’s degree in data science/analytics

Tools

Toad

SQL Developer

Power BI

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/Analyst, with keen analytical skills and an eye for detail, to join our growing team. The Audit Engineer/Analyst 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

• Working knowledge of SQL, including joins, aggregations, filtering, and subqueries/CTEs. Experience with Oracle is a plus
• Familiarity with window functions, and running totals, or the ability to learn them quickly.
• Experience loading or importing data into a database with a tool like Toad, SQL Developer, or similar
• Experience building reports or dashboards in Power BI or another BI tool
• Comfortable checking query results for accuracy and maintaining existing queries.
• 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.

Licenses & Certifications

Bachelor’s degree in data science, or analytics degree and/or similar discipline

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
• Basic understanding of how data is organized for reporting, such as fact and dimension tables
• Exposure to Toad for Oracle specifically or similar application

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”.