Pharmacy Benefits Audit Operations Analyst

🔥 15 hours ago

🇺🇸 United States – Remote

💵 $78.8k - $145.1k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

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👻 Ghost score 0%

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Milliman

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1947

🏥 Healthcare

🛡️ Insurance

💼 Consulting

Healthcare • Insurance • Consulting

Milliman is an independent global actuarial and consulting firm founded in 1947 that provides expertise in insurance, healthcare, retirement and employee benefits, risk management, and related financial services. The firm combines actuarial rigor, data science, and technology to deliver consulting, modeling, software, and advisory solutions to public- and private-sector clients addressing challenges such as healthcare costs, market volatility, climate risk, and program design. Milliman operates worldwide with multidisciplinary teams including actuaries, data scientists, clinicians, and software engineers.

📋 Description

• Support 20 or more concurrent audit and consulting engagements • Load, clean, and validate claims, eligibility, pharmacy, and rebate data 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 project schedules, milestones, and deliverable due dates • Work with clients, PBMs, third-party administrators, carriers, and other vendors to resolve data and report questions • Prepare audit data requests, track PBM and client responses, and escalate timeline risks • 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 before client release

🎯 Requirements

• 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 • 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 • Highly organized with consistent follow-through • Independent judgment and decision-making • Ownership and accountability • Collaborative approach and critical thinking • Legally authorized to work in the United States without immigration support or sponsorship from Milliman now or in the future

🏖️ Benefits

• Medical, Dental and Vision coverage for employees, dependents, and domestic partners • Employee Assistance Program (EAP) • 401(k) Plan with company matching and profit-sharing contributions • Discretionary Bonus Program • Flexible Spending Accounts (FSA) • Paid Time Off (PTO); full-time employees accrue 15 days per year • Minimum of 10 paid holidays per year • Family Building Benefits, including adoption and fertility assistance • 11 weeks of Paid Parental Leave for eligible employees • Life Insurance & AD&D with 100% of premiums covered by Milliman • Short-Term and Long-Term Disability fully paid by Milliman • Skills training and career development • Learning and mentoring opportunities • Employee Resource Groups (ERGs)