Pharmacy Audit Engineer

Job not on LinkedIn

🔥 2 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $75k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Brown & Brown Insurance

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1939

💸 Finance

🛡️ Insurance

Finance • Insurance

Brown & Brown Insurance is one of the largest independent insurance brokerages globally, providing a comprehensive range of risk management solutions. Established in 1939, the company offers personal and business insurance, employee benefits, and various national programs. Brown & Brown is committed to diversity, inclusion, and belonging, fostering a culture that values talent and experience. With over 500 locations, the company is well-positioned to meet the diverse needs of its clientele and is listed on the New York Stock Exchange under the ticker BRO. The firm's strategic focus on mergers and acquisitions highlights its disciplined growth strategy.

📋 Description

• Complete pharmacy claims audits to ensure compliance with PBM contracts • Facilitate calls with PBMs and obtain claims audit data • Perform data loading, data quality checks, and data reconciliation • Run and analyze Oracle output reports • Perform ad-hoc analysis • Review PBM contracts • Complete audit support documentation • Work with the client support team to develop PBM and client deliverables • Utilize ad hoc SQL automation and build a highly customized framework to complete projects • Develop, prioritize, and conduct financial and operational audits evaluating PBM contracts, controls, and financial information accuracy • Plan and develop audit approaches for assigned projects according to Remedy internal Audit Standards • Work simultaneously on multiple audits with differing deadlines • Analyze and quality-check master files, profiles, and table changes • Improve audit automation transforms based on findings, industry changes, and technology updates • Track open audit observations and follow up on remediation efforts with PBM and Remedy account teams • Draft audit reports communicating analysis results to the Remedy account team • Perform daily/weekly ad hoc data analytics requests as prioritized by Department Management • Re-evaluate system functionality to identify operational efficiency improvements • Comply with regulatory compliance areas, policies, procedures, HIPAA requirements, and leading practices

🎯 Requirements

• 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.) • 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 • Preferred but not required: Experience with version control (git, bitbucket) • Preferred but not required: Familiarity with Visualization tools (PowerBI/SSRS preferred) • Preferred but not required: Proficiency in Python (pandas, NumPy, general data manipulation techniques) • Preferred but not required: Familiarity with low code to no code solutions • Preferred but not required: Experience working with Pharmacy and/or Medical claims data • Preferred but not required: Pharmacy claims audit experience &/or knowledge of pharmacy claims data

🏖️ Benefits

• 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 • Paid Time Off • Holidays • Preferred Partner Discounts