[Hiring] Pharmacy Audit Engineer @Brown & Brown Insurance

Role Description

Brown & Brown / Remedy Analytics is looking for a full-time experienced Pharmacy Audit Engineer, with keen analytical skills and an eye for detail, to join our growing team. The 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
• Performing 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
• Working with the client support team to develop PBM & client deliverables
• Utilizing ad hoc SQL automation and building a highly customized framework to complete projects
• Developing, prioritizing, and conducting financial and operational audits to evaluate the effectiveness of PBM contracts, controls, and accuracy of financial information

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
• 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
• Comply with and adhere to all regulatory compliance areas, policies, and procedures (including HIPAA requirements), and "leading practices"

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
• Relevant experience that demonstrates problem-solving, financial acumen, and analytical output
• Proficiency in MS Office applications (Excel, Word, Powerpoint, PowerBI etc.)
• 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

Requirements

• 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 (preferred but not required)

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
• Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more

Pay Range

$75,000 - $90,000 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.