Pharmacy Data Management is hiring a
Pharmacy Network Audit Analyst

Summary

PDMI is seeking a Pharmacy Network Audit Analyst to join their team. This role involves coordinating and executing detailed audits, identifying potential Fraud, Waste, and Abuse (FWA), and maintaining high standards in quality assurance, data analysis, and operational reporting. The company offers a flexible work environment, was voted a Best Employer in Ohio for the 3rd consecutive year in 2023, and provides opportunities for meaningful work and exciting challenges.

Requirements

• Educational Background: Bachelor’s degree in health administration, healthcare analytics, business, or finance. Relevant industry experience may be considered
• Experience: A minimum of three years in a pharmacy analyst role, with experience in auditing, compliance, or as a pharmacy technician being a strong plus
• Technical Proficiency: Expertise in SQL, Excel, and other database tools, with the ability to develop and analyze complex datasets

Responsibilities

• Audit Leadership: Track, monitor, and manage pharmacy and claim audits, ensuring a seamless process from initiation to completion
• Client and Pharmacy Liaison: Act as the primary contact for clients and pharmacies regarding audit procedures, ensuring clear communication and resolution
• Data-Driven Insights: Compile and analyze data to identify potential FWA, and provide actionable insights to prevent future occurrences
• Quality Assurance: Develop and implement quality assurance standards that exceed industry best practices
• Policy Development: Create and publish policies and procedures for all aspects of pharmacy network audits
• Operational Excellence: Assist in the maintenance and update of pharmacy network information and contribute to the enhancement of MAC operations

Benefits

• Best Employer: PDMI was voted a Best Employer in Ohio for the 3rd consecutive year in 2023!
• Meaningful Work: Contribute to improving healthcare quality and efficiency
• Collaborative Environment: Work with passionate professionals who share your drive
• Exciting Challenges: Every day brings new opportunities to excel
• Flexible Work: Fully remote opportunity with a company that cares