Senior Client Audit Engineer - Pharmacy

Brown & Brown Insurance; United States; Remote; USD 85,000 - 100,000; Full time

Benefits offered by this job

Health benefits

401k

Student loan assistance

Tuition reimbursement

Mental health & wellness

Job summary

Brown & Brown Remedy Analytics is seeking a Senior Client Audit Engineer - Pharmacy to lead pharmacy claims audits, ensure PBM contract compliance, and drive data quality and automation initiatives. You will interface with PBMs, load and validate data, review contracts, and deliver insightful audit reports.

You will collaborate with engineering and product teams to prototype solutions, perform analytics, and support the client success team with deliverables and improvements.

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.
• Experience solving problems with financial acumen and analytical output.
• Ability to thrive in a fast-paced environment, follow instructions, and develop efficiencies on repeat tasks.
• Excellent verbal and written communication to assemble data.

Responsibilities

• Plan and develop the audit approach for assigned projects per Remedy standards.
• Manage multiple audits with different deadlines while maintaining accuracy.
• Analyze master files, profiles, and table changes for accuracy.
• Improve audit automation transforms based on findings and tech updates.
• Track audit observations and follow up on remediation with PBM and Remedy teams.
• Draft audit reports communicating results to the account team.
• Perform ad hoc data analytics as prioritized by management.
• Collaborate with engineering and product teams to prototype data pipelines using Python/SQL.

Skills

Python

SQL

Data analytics

ETL

Oracle/SQL

Communication

Problem solving

Project management

Collaboration

Education

Bachelor's degree in computer science or engineering

Tools

Git

Bitbucket

Power BI

SSRS

Job description

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

Brown & Brown Remedy Analytics is looking for a full-time experienced Senior Client Audit Engineer - Pharmacy. The Senior Client Audit Engineer will be responsible for completing pharmacy claims audits to ensure compliance to PBM contracts. This role will involve facilitating calls with PBMs, obtaining claims audit data, perform data loading and data quality checks, data reconciliation, running and analyzing Oracle output reports, running ad-hoc analysis, reviewing PBM contracts, completing audit support documentation and working with the client support team to develop PBM & client deliverables.

How You Will Contribute:

• 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
• Maintain and 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.
• Develop the necessary tools, templates and reporting required to support any/all process improvement initiatives
• Aid in the training of new internal audit staff
• Comply with and adhere to all regulatory compliance areas, policies, and procedures (including HIPAA requirements), and “leading practices”.
• Complete quality checks for junior level auditors
• Develop audit automation transforms for new PBMs
• Collaborate with engineering and product teams to prototype solutions and validate data pipelines using Python and SQL

Skills & Experience to be Successful:

• 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
• 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.
• Must be able to adapt to change in direction and priorities in a project and deadline-oriented environment.

Preferred but not required

• Experience in Project Management
• Experience with version control (git, bitbucket)
• Familiarity with Visualization tools (PowerBI/SSRS preferred)
• Proficiency in Python (pandas, NumPy, general data manipulation techniques)
• Familiarity with low code to no code solutions
• 3-5 years of experience working with Pharmacy claims data (required)
• Pharmacy claims audit experience &/or knowledge of pharmacy claims data (required)

Pay Range

$85,000 - $100,000 Annual

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.

Teammate Benefits & Total Well-Being

We go beyond standard benefits, focusing on the total well-being of our teammates, including:

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
• Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
• Mental Health & Wellness: Free Mental Health &Enhanced Advocacy Services
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.

Recruiting Vendor Disclosure Statement

Brown & Brown does not accept unsolicited resumes from external recruiters, recruitment vendors or employment agencies (“Recruiting Vendors”). Recruiting Vendors must have a valid written agreement and received prior written authorization from an authorized Brown & Brown representative before submitting candidates for any publicly posted role. Any unsolicited resumes submitted to Brown & Brown or its employees become the property of Brown & Brown, and no fees will be paid for such submissions. Additional information regarding this policy can be found on our careers page.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.