Pharmacy Fraud & Risk Analyst

RedSail Technologies; Cranberry Lake (NY); Hybrid; USD 95,000 - 115,000; Full time

Benefits offered by this job

Paid time off

Medical insurance

Dental insurance

Vision insurance

401(k) match

Fitness bonus

Professional development

Well-being programs

Job summary

RedSail Technologies is seeking a Business Analyst (RAS) to monitor account activity, review sensitive data, and analyze operational information to identify risks and improve business controls. The role emphasizes discretion and collaboration across teams to support fair customer experiences.

The analyst will compare data across RAS/PowerLine and PMS, document outcomes, and recommend corrective actions while maintaining confidentiality and accuracy.

Qualifications

• Bachelor’s degree in business, finance, healthcare administration, criminal justice, data analytics is required.
• Requires 3–5 years of experience in the pharmacy industry.
• Experience with pharmacy workflows, account activity review, and data interpretation is essential.

Responsibilities

• Review account activity for unusual or non-compliant patterns and document findings.
• Conduct proactive reviews of randomly selected accounts to identify risks.
• Analyze data from RAS/PowerLine and PMS to spot inconsistencies and trends.
• Validate activity in the PMS to support reviews and investigations.
• Document findings and recommendations for leadership and partners.
• Collaborate with teams to escalate findings and strengthen controls.
• Lead assigned reviews and projects to ensure timely completion.

Skills

Pharmacy workflows

Data analysis

Investigative skills

Attention to detail

Communication

MS Office

Data interpretation

Education

Bachelor’s degree in business, finance, healthcare administration, criminal justice, data analytics

Tools

RAS

PowerLine

PMS platforms

Job description

RedSail Technologies is seeking a Business Analyst (RAS) to monitor account activity, review sensitive data, and analyze operational information to identify risks and improve business controls. The role emphasizes discretion and collaboration across teams to support fair customer experiences.

The analyst will compare data across RAS/PowerLine and PMS, document outcomes, and recommend corrective actions while maintaining confidentiality and accuracy.