Pharmacy Claims Audit Engineer

Brown & Brown, Inc.; Town of Grand Rapids (WI); On-site; USD 75,000 - 90,000; Full time

Benefits offered by this job

Health benefits

401k

Paid time off

Dental and Vision insurance

Job summary

Brown & Brown / Remedy Analytics is seeking a full-time experienced Pharmacy Audit Engineer to join our growing team in a data-driven audit role. You will lead pharmacy claims audits, collect data, perform loading and quality checks, and create client-ready deliverables using SQL and Oracle reports.

The role emphasizes developing automated audit solutions, reviewing PBM contracts, and delivering analytics to support remediation and client success.

Qualifications

• 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.

Responsibilities

• 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

Analytical skills

Attention to detail

Communication skills

Problem-solving

Fast-paced environment

Education

Bachelor's degree in computer science/engineering

Tools

Oracle/SQL

PowerBI

Python (pandas, NumPy)

Git/Bitbucket

Job description

Brown & Brown / Remedy Analytics is seeking a full-time experienced Pharmacy Audit Engineer to join our growing team in a data-driven audit role. You will lead pharmacy claims audits, collect data, perform loading and quality checks, and create client-ready deliverables using SQL and Oracle reports.

The role emphasizes developing automated audit solutions, reviewing PBM contracts, and delivering analytics to support remediation and client success.