Pharmacy Contract Audit Analyst
Job Summary
To support a growing team, the full-time remote Pharmacy Contract Audit Analyst will oversee the accuracy of pharmacy network reimbursement, analyze claims data, and ensure compliance with contractual obligations across Retail, Specialty, and Mail Order agreements.
Key responsibilities
- Field, analyze, and resolve inquiries regarding pricing errors from pharmacy providers, clients, and internal teams
- Interpret pharmacy contract language to compare contract pricing against adjudicated claims activity
- Develop and maintain oversight reporting and controls for the end-to-end process of contract pricing
Required qualifications
- Bachelor's degree or equivalent experience, preferably in business, finance, economics, or operations
- Minimum two years of analytics experience
- Ability to support compliance program objectives
- Experience in pharmacy network rate testing and analysis
- Familiarity with pricing structures such as AWP, WAC, and MAC
Complete Job Description
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