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Job Summary:
Responsible for leading complex pharmacy claim audits, ensuring compliance with client-specific requirements, and delivering advanced data analysis to identify trends, risks, and opportunities for improvement. This role involves managing high-risk audits, investigating fraud or discrepancies, and presenting comprehensive reports with actionable recommendations. The Auditor provides strategic insights through advanced data analysis, predictive modeling, and the development of sophisticated dashboards to support client decision-making and cost-saving initiatives.
Acting as a trusted advisor, this role manages senior-level client relationships, leads discussions on audit findings, and collaborates on customized strategies to optimize pharmacy operations. Additionally, the position includes reviewing deliverables, and driving team projects to enhance audit processes and tools. With expertise in regulatory compliance, including HIPAA, the Auditor ensures adherence to industry standards and provides guidance to clients and internal teams. This role also focuses on continuous improvement, innovation, and strategic initiatives to enhance client satisfaction, operational efficiency, and risk management.
B.S. degree
3-5 years experience
Experience as a Pharmacy Tech and project managment within PBM ideal
At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.
At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.
Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)
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