Pharmacy Benefit Auditor (CPhT)

Job Summary

A company is looking for a Pharmacy Benefit Auditor to support clients by analyzing PBM claims data and ensuring compliance with contracts.

Key Responsibilities

• Conduct data analysis for pharmacy benefit audits related to pharmacy claims
• Implement and finalize audit rules and requirements from clients and PBMs
• Generate audit reports and consult with clients on findings

Required Qualifications

• Pharmacy Technician Certification (CPhT) and/or pharmacy work experience
• Associate degree or higher (preferred)
• 3 to 5 years of experience in healthcare or health insurance, focusing on pharmacy benefit management
• Direct PBM claims auditing experience (preferred)
• Ability to maintain confidentiality and build collaborative relationships