Director, PBM Contract Audit @EPIC Brokers

[Hiring] Director, PBM Contract Audit @EPIC Brokers

Mar 19, 2025 - EPIC Brokers is hiring a remote Director, PBM Contract Audit. 💸 Salary: $140,000 to $180,000. 📍Location: USA.

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Role Description

The Director of Audit Services will be responsible for establishing strategic direction and for the leadership, development, and production of PSG audit services. The Director will understand the business needs of our clients and create audit solutions for clients from all PSG client market segments: Employer, Labor, Hospital and Health Plan (including those programs dictated by participation in government programs, e.g. Medicaid and Medicare D).

Oversee the development of audit work plans, tools, and methodologies
Execute financial, operational, and compliance audits specific to pharmacy management services
Manage timelines and deliverables of the team in a fast-paced environment
Manage and mentor a team of seasoned auditors
Prepare and execute a resource capacity plan and resource schedules
Support audit business development opportunities and marketing content
Establish and maintain key relationships with internal executives and external stakeholders (clients and vendors)
Serve as a subject matter expert with deep understanding and knowledge of PBM contracts and terms
Utilize PSG’s proprietary Compliance Model
Document all potential issues and track decisions including escalations
Collaborate with account management and pharmacy consultants to discuss and present results with clients and vendors
Work with IT to further develop Compliance Model logic and capabilities
Assist in other financial projects as needed

Qualifications

Bachelor’s degree in Business, Finance, or a health-related field
5 years of leadership experience
At least 7 years of either a) pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms
Working knowledge of the PBM industry and pharmacy benefit claims
Proficient in Microsoft Office, with extensive experience working with Excel
Proficient in SQL to extract data and build queries
Ability to effectively develop and maintain strong working relationships with internal and external stakeholders
Strong written and verbal communication skills
Discipline to multitask and prioritize projects to meet scheduled deadlines
Strong analytical, problem-solving, organization, critical thinking, and time management skills
Excellent attention to detail and quality
Previous Medicare Part D experience preferred
Ability to interact with diverse group of stakeholders including executives, managers, clients, and subject matter experts both technical and non-technical
Solid, independent worker (work from home)
Ability for some travel (5% - 10%)

Requirements

The national average salary for this role is $140,000 to $180,000 in base pay and exclusive of any bonuses or benefits.
The base pay offered will be determined based on your experience, skills, training, certifications and education, while also considering internal equity and market data.

Benefits

Generous Paid Time off
Managed PTO for salaried/exempt employees (personal time off without accruals or caps); 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days
Generous leave time options: Paid parental leave, pregnancy disability and bonding leave, and organ donor/bone marrow donor leave
Generous employee referral bonus program of $1,500 per hired referral
Employee recognition programs for demonstrating EPIC’s values plus additional employee recognition awards and programs (and trips!)
Employee Resource Groups: Women’s Coalition, EPIC Veterans Group
Professional growth & development: Mentorship Program, Tuition Reimbursement Program, Leadership Development
Unique benefits such as Pet Insurance, Cancer Insurance, Identity Theft & Fraud Protection Coverage, Legal Planning, Family Planning, and Menopause & Midlife Support
Additional benefits include (but are not limited to): 401(k) matching, medical insurance, dental insurance, vision insurance, and wellness & employee assistance programs
50/50 Work Culture: EPIC fosters a 50/50 culture between producers and the rest of the business, supporting collaboration, teamwork, and an inclusive work environment.
EPIC Gives Back – Some of our charitable efforts include Donation Connection, Employee Assistance Fund, and People First Foundation
We’re in the top 10 of property/casualty agencies according to “Insurance Journal”

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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Director, PBM Contract Audit @EPIC Brokers

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Salary 💸 $140,000 to $180,000	Remote Location USA
Job Type full-time	Posted Mar 19, 2025

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📍	Be aware of the location restriction for this remote position: USA
‼	Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more.

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[Hiring] Director, PBM Contract Audit @EPIC Brokers

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