Senior Pharmacy Audit Lead - Hybrid, Growth & Innovation

Mercer; Atlanta (GA); Hybrid; USD 103,000 - 205,000; Full time

Job summary

Mercer is seeking a Pharmacy Audit Lead Consultant to lead complex pharmacy claims and rebate audits, applying deep expertise in PBMs, contracts, and rebate economics. The role is hybrid, based in the US, with a requirement to work at least three days a week in the office.

You will act as the primary audit SME, partnering with internal consultants to deliver defensible findings while driving growth and innovation in the practice.

Qualifications

• Bachelor’s degree in pharmacy, healthcare, business, finance, analytics, or related field.
• 8+ years of experience in pharmacy claims auditing, PBM operations, pharmacy benefit consulting, or health plan administration.
• Strong knowledge of pharmacy benefits, claims adjudication, formulary administration, and specialty pharmacy.
• Knowledge of PBM contract terms, pricing methodologies, and pharmacy rebate structures.

Responsibilities

• Lead end-to-end pharmacy claims and rebate audits for complex, high-visibility clients, identifying mispricing and misadjudication.
• Translate PBM contracts and rebate agreements into audit scope and defensible sample selection.
• Oversee claim and rebate review activity with consistent methodology and documentation.
• Quantify financial impact, evaluate vendor responses, and drive issues to resolution.
• Serve as primary client contact, presenting methodology, findings, and recommendations.
• Partner with internal consultants as the audit subject-matter expert.
• Identify opportunities to expand services and support business development.
• Mentor team members and ensure audit quality as a checkpoint.
• Thrive in an environment embracing AI and technology-enabled tools.

Skills

Pharmacy audits

Analytics

Client-facing

Leadership

PBM contracts

Education

Bachelor’s degree

Job description

Mercer is seeking a Pharmacy Audit Lead Consultant to lead complex pharmacy claims and rebate audits, applying deep expertise in PBMs, contracts, and rebate economics. The role is hybrid, based in the US, with a requirement to work at least three days a week in the office.

You will act as the primary audit SME, partnering with internal consultants to deliver defensible findings while driving growth and innovation in the practice.