Location: Indianapolis IN, Mason OH, Atlanta GA, Norfolk VA, Tampa FL

Hours: M – F East coast Hours of Operation

Travel: Hybrid 1 ( 1-2 Days onsite per week)

Position Overview:

Responsible for handling high level pharmaceutical claim audits and reviewing claims issues from junior team to ensure claims are being resolved and reported in a timely manner.

How You Will Make an Impact:

• Reviews and Audits Pharmaceutical claims processed by vendors to ensure proper compliance

• Conducting Data analysis and issue resolution regularly

• Acts as a resource to users of PBM software to address questions/issues

• Vendor interaction and stakeholder management responsibilities

• Develops project plans and identifies and coordinates resources, involving those outside the unit

• Works with programming staff to ensure requirements will be incorporated into system design and testing

• May provide direction and guidance to team members and serves as an expert for the team

Required Qualifications:

• Requires a BA/BS and minimum of 5 years business analysis experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications:

• Pharmacy Claims Audit Strongly preferred

• PBM (Pharmacy Benefit Management) Software Experience Strongly preferred

• Experience working in an Agile environment strongly preferred

• PBM(Pharmacy Benefit Management) Benefits experience preferred

• Healthcare experience Strongly preferred

• Data analysis and issue resolution experience preferred

• SQL experience is preferred

If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed.