Pharmacy Benefit Audit Manager: Lead Claims & Compliance

Myers & Stauffer; Baltimore (MD); On-site; USD 110,000 - 160,000; Full time

Benefits offered by this job

Health, Dental, and Vision insurance

Vacation and paid holidays

Parental Leave

401K with company matching

Tuition reimbursement

Referral bonuses

Volunteer time and mentor program

Employee development training

Employee Assistance Program

Job summary

Myers and Stauffer LC is seeking a Pharmacy Benefit Audit Manager to lead audit engagements for government PBM programs, ensuring accurate, compliant work products delivered on schedule. You will supervise staff, coordinate schedules, and collaborate with multiple offices while maintaining strict confidentiality of health information.

The role emphasizes project management, data analysis, and effective communication with clients and PBMs.

Qualifications

• Bachelor’s degree required.
• Experience managing project deliverables and staff.
• Proficient with MS Office (Excel, Word, PowerPoint).
• Familiarity with SQL databases.
• Strong analytical and problem-solving skills.
• Well organized with high accuracy and attention to detail.
• Able to manage multiple deadlines and prioritize staff.
• Strong verbal and written communication, report and proposal writing, presentation, and business development skills.
• Minimum of 3 years of PBM/health plan/claims auditor experience.
• Familiarity with PBM contracts and auditing guidelines.
• Client audit experience desirable.
• Occasional travel may be required.

Responsibilities

• Lead staff on engagements and review analysts’ deliverables.
• Coordinate schedules and assignments of engagement staff.
• Meet with clients and their PBMs.
• Develop criteria and programs to analyze pharmacy claims data.
• Review and interpret pharmacy claims data outputs.
• Use spreadsheets to format data for clients.
• Collaborate with multi-disciplinary teams across offices.
• Maintain confidentiality of protected health information and proper documentation.
• Keep documentation in a centralized tracking system.
• Deliver high-quality work within deadlines and support business development.

Skills

Project management

Staff supervision

Data analysis

Communication

Time management

Problem solving

Attention to detail

Business development

Education

Bachelor’s degree

Tools

Microsoft Office

SQL

Job description

Myers and Stauffer LC is seeking a Pharmacy Benefit Audit Manager to lead audit engagements for government PBM programs, ensuring accurate, compliant work products delivered on schedule. You will supervise staff, coordinate schedules, and collaborate with multiple offices while maintaining strict confidentiality of health information.

The role emphasizes project management, data analysis, and effective communication with clients and PBMs.