Remote Pharmacy Benefits Audit Specialist

Ultipro; San Diego (CA); Hybrid; USD 91,000 - 145,000; Full time

Benefits offered by this job

Medical, Dental & Vision

401(k) & matching

Discretionary bonus

Paid time off

Holidays

Life Insurance & AD&D

Short/Long disability

Job summary

Milliman seeks a Pharmacy Benefits Audit Operations Analyst to join our San Diego Health practice. This role may be performed remotely.

You will support 20+ concurrent audit and consulting engagements by analyzing pharmacy claims, eligibility, rebate, and pricing data using Excel and SQL, and by coordinating project schedules with clients, PBMs, and other vendors. Strong organizational, communication, and follow-through skills are essential as you will lead sessions, track deliverables, and

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 2+ years of relevant experience in data analysis, project management, consulting, or a related field preferred
• Pharmacy benefits or PBM industry experience preferred
• PMP, CAPM, or pharmacy-specific credentials (e.g., CPhT) preferred
• Demonstrated ability to manage multiple concurrent projects and competing deadlines with limited oversight
• Experience interacting directly with clients, vendors, or senior stakeholders
• Proficiency in Excel, PowerPoint, Outlook, Planner, OneNote and other project management or task-tracking systems
• Strong written and verbal communication skills, including clear and professional client correspondence and comfort presenting to leadership
• Familiarity with claims data or basic SQL a plus

Responsibilities

• Load, clean, and validate claims, eligibility, pharmacy, and rebate data received from PBMs, clients, and other vendors
• Write and modify basic SQL queries and excel models to summarize claims data, reconcile totals to PBM reporting, and prepare exhibits for consultant review
• Manage the day-to-day execution of 20 or more concurrent audit and client engagements, maintaining project schedules, milestones, and deliverable due dates.
• Work with clients, PBMs, third-party administrators, carriers, and other vendors to resolve open data and report questions that arise during an audit
• Prepare audit data requests, track PBM and client responses, and elevate delays that place timelines at risk.
• Lead internal and client working sessions, including agendas, meeting notes, action items, and follow-up.
• Track workload and capacity across consultants and analysts to align staffing with project demand.
• Review deliverables for completeness, consistency, and formatting prior to client release

Skills

Excel

PowerPoint

Outlook

Planner

OneNote

Client communication

SQL basics

Data analysis

Project management

Education

Bachelor's degree or equivalent

Job description

Milliman seeks a Pharmacy Benefits Audit Operations Analyst to join our San Diego Health practice. This role may be performed remotely.

You will support 20+ concurrent audit and consulting engagements by analyzing pharmacy claims, eligibility, rebate, and pricing data using Excel and SQL, and by coordinating project schedules with clients, PBMs, and other vendors. Strong organizational, communication, and follow-through skills are essential as you will lead sessions, track deliverables, and