Pharmacy Benefits Auditor

6 days ago


New York, New York, United States Gallagher Benefit Services Full time
About Us

Gallagher Benefit Services is a leading provider of employee benefits solutions, dedicated to helping clients build environments where employees thrive.

We're committed to delivering exceptional service and expertise, ensuring our clients receive the best possible support in managing their benefit programs.

Job Summary

We're seeking a highly skilled Pharmacy Benefits Auditor to join our team. This role will be responsible for performing pharmacy audits, reviewing claims data, and ensuring compliance with contractual requirements and plan specifications.

The successful candidate will have a strong understanding of pharmacy benefit administration, excellent analytical skills, and the ability to effectively manage client expectations.

Responsibilities
  • Perform and support pharmacy audits to validate claim payment data and ensure compliance with contractual requirements and plan specifications.
  • Manage multiple projects simultaneously, prioritizing tasks and meeting deadlines.
  • Review and evaluate Administrative Services Agreements between employers and Pharmacy Benefit Managers (PBMs).
  • Analyze data and identify trends to improve audit processes and outcomes.
  • Communicate effectively with clients and PBMs, resolving issues and providing recommendations.
Requirements
  • Bachelor's degree in a relevant field, or equivalent experience.
  • At least 5 years' experience in pharmacy consulting, auditing, or a related field.
  • Strong knowledge of pharmacy benefit administration, including Medicare experience.
  • Excellent analytical and problem-solving skills, with attention to detail.
  • Ability to work independently and as part of a team, with effective communication skills.
Benefits
  • Competitive salary: $80,000 - $110,000 per year, depending on experience.
  • A comprehensive benefits package, including medical, dental, and vision coverage.
  • 401(k) and Roth options, with company match.
  • Tax-advantaged accounts (HSA, FSA), and educational expense reimbursement.
  • Digital mental health services, flexible work hours, and training programs.
What We Offer

We value diversity and inclusion, and strive to create an environment where everyone feels welcome and supported.

We offer opportunities for professional growth and development, with a focus on employee well-being and satisfaction.



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