Senior Auditor

Employer:

Description

OVERVIEW

AEC Rx, an Alera Group company, is seeking an experienced Senior Auditor to join our team in examining pharmacy benefits administered by Pharmacy Benefit Managers (PBMs) or Carriers.

Alera Group was founded in 2017 and has grown to become the 15th largest broker of US business. We are passionate about our clients' success in the areas of Employee Benefits, Property and Casualty Insurance, Retirement Plan Services, and Wealth Services. With a network of offices nationwide, our commitment to collaboration allows us to offer national resources combined with local service.

This role focuses on auditing PBM contractual terms for our clients, including claims processing, rebate administration, and plan designs. Key responsibilities include conducting in-depth reviews of pharmacy claim transactions within contract terms to determine if all performance guarantees are met. The ideal candidate will possess expertise in PBM systems, strong analytical skills, and the ability to effectively communicate findings and recommendations to stakeholders.

This is a remote opportunity requiring availability during Eastern or Central Time Zone business hours.

RESPONSIBILITIES

Conduct audits of pharmacy claims, pricing, discounts, rebates, and plan designs to ensure compliance with contractual terms. Leverage internal software and other tools to perform detailed analyses and identify discrepancies and areas for improvement.
Communicate the audit scope, requirements, timelines, and deliverables clearly with PBMs/Carriers. Maintain organized records of received materials and follow up promptly on any outstanding items.
Produce detailed audit reports upon completion of each audit, clearly outlining what was reviewed and the findings. Share these reports with PBMs/Carriers, emphasizing key findings and observations.
After completing all audit activities with PBMs/Carriers, prepare a final audit report to be shared with all stakeholders, including the client. Be prepared to guide the client through the findings and provide additional context as needed.
Monitor and track unresolved issues by working proactively with stakeholders.
Ensure all audit deliverables meet established quality standards and are submitted within the agreed-upon timelines.

QUALIFICATIONS

Bachelor's degree in accounting, finance, healthcare administration, or a related field. CPA and/or CIA licenses preferred
5+ years of experience in an auditor role or similar position within the PBM, healthcare, or pharmaceutical industry.
2+ years of experience with a top-tier accounting/consulting firm is a plus.
Extensive proficiency in Tableau (loading data files, analyzing data, and creating visualizations), Microsoft Excel, and other Microsoft Office tools.
Proven experience generating client-facing reports and analytics.

BENEFITS

Alera Group offers comprehensive benefits to our colleagues, including medical, dental, life and disability insurance, 401k, generous paid time off and much more.

Salary range is $125K to 150K per year plus bonus. Compensation will vary based on experience.

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected class.

If you're a California resident, please read the California Consumer Privacy Act prior to applying.

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