Pharmacy Audit Lead — Team Leader & Process Optimizer

Judi Health, LLC; Port Charlotte (FL); Hybrid; USD 92,000 - 103,000; Full time

Job summary

Judi Health, LLC is seeking a Pharmacy Audit Lead to drive audit quality and manage a team through daily operations. You will assign work, monitor performance, and coach staff while personally conducting audits and reviewing claims and documentation.

Responsibilities include maintaining SOPs, preparing client-ready reports, and using metrics to improve processes. A strong background in pharmacy operations and PBM auditing is required, with a focus on accuracy and timely deliverables.

Qualifications

• Bachelor's degree or equivalent experience in a related field.
• Active pharmacy technician certification or registration required.
• Four to six years of pharmacy or PBM auditing experience, including direct pharmacy audits and team lead experience.
• Strong knowledge of pharmacy operations, billing, audit and documentation requirements, and pharmacy contracts.
• Strong analytical, organizational, problem-solving, documentation, communication, and prioritization skills.
• Proficiency in Microsoft Excel, Word, and applicable audit, workflow, and reporting tools.

Responsibilities

• Assign, rotate, and prioritize audit work; set expectations and maintain operating standards.
• Monitor inventory, productivity, deadlines, quality, capacity, and staffing needs; resolve barriers and escalations.
• Lead team huddles and case reviews; coach and train staff; and serve as the first escalation point for audit and workflow issues.
• Maintain pharmacy audit SOPs, procedures, job aids, and templates, including version control and scheduled reviews.
• Personally conduct pharmacy audits, including claims and documentation review.
• Validate findings, evidence, recovery calculations, reports, and correspondence before finalization.
• Manage audit inventory, daily claims review, deadlines, disputes, appeals, recoveries, vendor work, and client deliverables.
• Prepare audit reports, trend summaries, and client or management materials.
• Use audit results and operational metrics to improve workflows, controls, systems, turnaround times, and team efficiency.
• Maintain reporting for inventory, productivity, quality, recoveries, deadlines, and capacity; support practical system or automation improvements.
• Serve as the pharmacy audit subject matter resource for clients and internal partners.
• Partner across Compliance, Legal, Client Services, Provider Relations, Payment Integrity, Finance, Product, Commercial, and technology; elevate risks and suspected fraud, waste, abuse, or intentional misconduct.
• Support workload forecasting, staffing assessments, insourcing readiness, and product or commercial initiatives with audit and capacity data.

Skills

Audit management

Analytical skills

Communication

Attention to detail

Excel

Problem-solving

Education

Bachelor's degree in Business, Accounting, Healthcare Administration, or related field

Active pharmacy technician certification or registration

Active pharmacist license preferred

Tools

Audit software

Workflow tools

Reporting tools

Job description

Judi Health, LLC is seeking a Pharmacy Audit Lead to drive audit quality and manage a team through daily operations. You will assign work, monitor performance, and coach staff while personally conducting audits and reviewing claims and documentation.

Responsibilities include maintaining SOPs, preparing client-ready reports, and using metrics to improve processes. A strong background in pharmacy operations and PBM auditing is required, with a focus on accuracy and timely deliverables.