WHY THIS ROLE MATTERS:

To conduct high quality and detailed Prescription Drug Claim Audits on behalf of our clients. This includes analyzing Prescription Drug claims data, detecting and evaluating patterns, trends and anomalies, and turning them into meaningful insights and recommendations for our clients through formal written reports and presentations.

A component of this role includes supporting our consulting team as a technical resource. Conducting technical reviews, insights, and recommendations for the Prescription Drug portion of our clients Group Benefits plans. Keeping up with key industry trends, new products, and processes is highly valued.

WHAT YOU’LL BE RESPONSIBLE FOR :

•Conduct high quality, detailed, Drug claim audits; evaluate adjudication processes, error rate, test plan eligibility and adherence to the insurance contracts

•Review, interpret, and summarize plan designs from insurance contracts