Case Development Specialist

Job Summary

A company is looking for a Case Development Specialist who supports Pharmacy Audit and FWA investigation teams by managing case intake and documentation processes.

Key Responsibilities

• Enter and track new cases for Pharmacy Audit and FWA Investigation teams
• Complete risk assessments and maintain organized case files according to SIU standards
• Analyze claims and patient data to identify patterns of abnormal utilization or fraud

Required Qualifications

• 2+ years of experience in healthcare, PBM, or insurance (SIU or audit experience preferred)
• Proficiency with case management systems and Microsoft Office, particularly Excel
• Ability to handle confidential and sensitive information
• Strong organizational and data management skills
• Associate or bachelor's degree preferred