Pharmacy Benefits Audit Operations Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist in managing over 20 simultaneous audit and consulting projects.

• Import, cleanse, and verify claims, eligibility, pharmacy, and rebate information from PBMs, clients, and various vendors.

• Develop and adjust basic SQL queries and Excel models to summarize claims information.

• Reconcile figures with PBM reports and create exhibits for consultant evaluation.

• Oversee project timelines, key milestones, and due dates for deliverables.

• Collaborate with clients, PBMs, third-party administrators, carriers, and other vendors to address data and reporting inquiries.

• Prepare requests for audit data, monitor responses from PBMs and clients, and escalate potential timeline issues.

• Facilitate internal and client working sessions, including setting agendas, taking meeting notes, documenting action items, and ensuring follow-up.

• Monitor workload and capacity among consultants and analysts to ensure appropriate staffing aligns with project needs.

• Review deliverables for accuracy, coherence, and formatting before they are sent to clients.

⛳️ Requirements

• A bachelor's degree or a comparable combination of education and experience.

• At least 2 years of relevant experience in data analysis, project management, consulting, or a related discipline is preferred.

• Experience in the pharmacy benefits or PBM sector is preferred.

• Possession of PMP, CAPM, or pharmacy-specific certifications (e.g., CPhT) is preferred.

• Capability to handle multiple concurrent projects and meet competing deadlines with minimal supervision.

• Experience in direct interactions with clients, vendors, or senior stakeholders.

• Proficient in Excel, PowerPoint, Outlook, Planner, OneNote, and other project management or task-tracking tools.

• Excellent written and verbal communication skills, including professional client correspondence and comfort in presenting to leadership.

• Familiarity with claims data or basic SQL is a plus.

• Highly organized with a consistent follow-through.

• Ability to exercise independent judgment and decision-making.

• Strong sense of ownership and accountability.

• Collaborative mindset and critical thinking abilities.

• Legally authorized to work in the United States without the need for 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 earn 15 days per year.

• A minimum of 10 paid holidays each 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 covered by Milliman.

• Skills training and career development opportunities.

• Learning and mentoring prospects.

• Employee Resource Groups (ERGs).