Pharmacy Auditor

Gallagher•Rolling Meadows, IL

19h

About The Position

Position Summary: Responsible for conducting detailed audits of pharmacy claims, ensuring compliance with client-specific requirements, and analyzing pharmacy data to identify discrepancies, trends, and opportunities for improvement. This role involves auditing claims to detect fraud, waste, or abuse, preparing comprehensive audit reports with actionable recommendations, and collaborating with clients and internal teams to resolve findings and implement corrective measures. The Analyst/Auditor also analyzes claims data to uncover trends and risks, develops client-specific dashboards and reports, and provides insights to support decision-making and cost-saving initiatives. Acting as the primary client contact for audit and compliance matters, this role ensures adherence to regulatory standards, including HIPAA, and supports clients in meeting compliance requirements. Additionally, the position emphasizes collaboration with internal teams, continuous improvement of audit processes, and participation in strategic initiatives to enhance client satisfaction and operational efficiency.

Requirements

Typically requires a University Degree or equivalent experience and minimum 3 years of prior relevant experience.
Strong attention to detail and organizational skills.
Basic analytical and problem-solving abilities.
Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
Strong written and verbal communication skills.
Willingness to learn and adapt in a fast-paced environment.
Ability to work collaboratively as part of a team.
Interest in pharmacy operations, compliance, and data analysis.

Nice To Haves

Degree in Healthcare Administration, Business, Data Analytics, or a related field.
Certified Pharmacy Technician (CPhT) or equivalent certification is a plus.
Experience working with clients in a consulting or service-oriented role is preferred.
Familiarity with pharmacy benefit management (PBM) processes and systems is a plus.
Experience with data analysis tools (e.g., Excel, SQL, Tableau) is preferred.

Responsibilities

Conducting detailed audits of pharmacy claims
Ensuring compliance with client-specific requirements
Analyzing pharmacy data to identify discrepancies, trends, and opportunities for improvement
Auditing claims to detect fraud, waste, or abuse
Preparing comprehensive audit reports with actionable recommendations
Collaborating with clients and internal teams to resolve findings and implement corrective measures
Analyzing claims data to uncover trends and risks
Developing client-specific dashboards and reports
Providing insights to support decision-making and cost-saving initiatives
Acting as the primary client contact for audit and compliance matters
Ensuring adherence to regulatory standards, including HIPAA
Supporting clients in meeting compliance requirements
Collaboration with internal teams
Continuous improvement of audit processes
Participation in strategic initiatives to enhance client satisfaction and operational efficiency

Benefits

Medical/dental/vision plans, which start from day one!
Life and accident insurance
401(K) and Roth options
Tax-advantaged accounts (HSA, FSA)
Educational expense reimbursement
Paid parental leave
Digital mental health services (Talkspace)
Flexible work hours (availability varies by office and job function)
Training programs
Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
Charitable matching gift program