Pharmacy Benefits Audit Operations Analyst

Milliman•San Diego, CA

1d•$78,800 - $145,130•Remote

About The Position

We are seeking a Pharmacy Benefits Audit Operations Analyst to join our Pharmacy Benefits Audit team in our San Diego Health practice. This position may be performed remotely. The analyst will support 20 or more concurrent audit and consulting engagements by analyzing pharmacy claims, eligibility, rebate, and pricing data using Excel and SQL, and by coordinating project schedules, data requests, and deliverables with clients, PBMs, and other vendors. This role requires strong organizational, communication, and follow-through skills.

Requirements

Bachelor's degree or equivalent combination of education and experience
2+ years of relevant experience in data analysis, project management, consulting, or a related field preferred
Pharmacy benefits or PBM industry experience preferred
PMP, CAPM, or pharmacy-specific credentials (e.g., CPhT) preferred
Demonstrated ability to manage multiple concurrent projects and competing deadlines with limited oversight
Experience interacting directly with clients, vendors, or senior stakeholders
Proficiency in Excel, PowerPoint, Outlook, Planner, OneNote and other project management or task-tracking systems
Strong written and verbal communication skills, including clear and professional client correspondence and comfort presenting to leadership
Familiarity with claims data or basic SQL a plus
Highly organized with consistent follow-through
Independent judgment and decision-making
Ownership and accountability
Collaborative approach and critical thinking
Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.

Responsibilities

Load, clean, and validate claims, eligibility, pharmacy, and rebate data received from PBMs, clients, and other vendors
Write and modify basic SQL queries and excel models to summarize claims data, reconcile totals to PBM reporting, and prepare exhibits for consultant review
Manage the day-to-day execution of 20 or more concurrent audit and client engagements, maintaining project schedules, milestones, and deliverable due dates.
Work with clients, PBMs, third-party administrators, carriers, and other vendors to resolve open data and report questions that arise during an audit
Prepare audit data requests, track PBM and client responses, and escalate delays that place timelines at risk.
Lead internal and client working sessions, including agendas, meeting notes, action items, and follow-up.
Track workload and capacity across consultants and analysts to align staffing with project demand.
Review deliverables for completeness, consistency, and formatting prior to client release.

Benefits

Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners.
Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges.
401(k) Plan – Includes a company matching program and profit-sharing contributions.
Discretionary Bonus Program – Recognizing employee contributions.
Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses.
Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis.
Holidays – A minimum of 10 paid holidays per year.
Family Building Benefits – Includes adoption and fertility assistance.
Paid Parental Leave – 11 weeks of paid leave for employees who meet eligibility criteria.
Life Insurance & AD&D – 100% of premiums covered by Milliman.
Short-Term and Long-Term Disability – Fully paid by Milliman.