Pharmacy Audit Lead Consultant
$102.5k - $204.5kMercer Consulting
We are seeking a talented individual to join our Health & Benefits team, part of our People and Investments business at Marsh. This role can be based near any of our US offices. This is a hybrid role that has a requirement of working at least three days a week in the office.
As a Pharmacy Audit Lead Consultant, you will lead complex pharmacy claims and pharmacy rebate audits from planning through final report, applying deep expertise in pharmacy benefits, PBM contracts, and rebate economics. You will act as the primary consultant and pharmacy audit subject-matter expert for our clients, partnering closely with internal consultants to deliver clear, defensible findings while driving growth and innovation across the practice.
We will count on you to:
Lead end-to-end pharmacy claims and rebate audits for complex, high-visibility clients, applying deep working knowledge of pharmacy claims data and every claim field and component (e.g., NDC, days' supply, quantity, ingredient cost, dispensing fee, copay/coinsurance, DAW code, prior authorization, and plan/formulary edits) to manually and analytically identify claims that were mispriced, misadjudicated, or paid outside of contract or plan terms.
Translate PBM contracts, pricing guarantees, formulary terms, and rebate agreements into audit scope and defensible sample selection using analytics/SaaS tools.
Oversee claim and rebate review activity, ensuring consistent methodology, sound judgment, and clear documentation across the team.
Quantify financial impact, evaluate vendor responses, and drive issues to final resolution.
Serve as primary client contact, presenting methodology, findings, and recommendations with clarity and confidence.
Partner with internal consultants as the pharmacy audit subject-matter expert.
Identify opportunities to expand services and support new business development, while driving innovation in audit methodology, tools, and practice capabilities.
Mentor team members and serve as a key quality checkpoint for audit work.
Thrive and be motivated by an environment that embraces AI and technology-enabled tools.
What you need to have:
Bachelor's degree in pharmacy, healthcare, business, finance, analytics, or related field.
Minimum of 8 years of experience in pharmacy claims auditing, PBM operations, pharmacy benefit consulting, or health plan administration.
Excellent knowledge of pharmacy benefits, claims adjudication, formulary administration, and specialty pharmacy, including strong command of pharmacy claim fields and data elements and what they indicate about how a claim was processed and paid.
Strong knowledge of PBM contract terms, pricing methodologies, and pharmacy rebate structures (guarantees, pass-through, reporting).
Client-facing experience in a consulting environment, with the ability to partner effectively with internal consultants.
What makes you stand out:
Demonstrated experience leading complex, analytics-driven pharmacy audits.
A growth- and innovation-oriented mindset, with a track record of improving processes, tools, or methodology and/or supporting business development.
Strong leadership presence, with the ability to mentor and elevate others while staying hands-on in audit execution.
Advanced degree, PharmD, RPh, MBA, CPA, or other relevant credential.
Experience with specialty pharmacy, Medicare Part D, or broader PBM financial performance audits.
Prior experience formally managing or supervising staff.
Why join our team:
We help you be your best through professional development opportunities, interesting work, and supportive leaders.
We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have an impact for colleagues, clients, and communities.
Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being.
Marsh (NYSE: MRSH) is a global leader in risk, reinsurance and capital, people and investments, and management consulting, advising clients in 130 countries. With annual revenue of over $27 billion and more than 95,000 colleagues, Marsh helps build the confidence to thrive through the power of perspective. For more information, visit marsh.com, or follow us on LinkedIn and X.
Marsh is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age background, disability, ethnic origin, family duties, gender orientation or expression, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, veteran status (including protected veterans), or any other characteristic protected by applicable law. If you have a need that requires accommodation, please let us know by contacting View email address on click.appcast.io. Marsh is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person. The applicable base salary range for this role is $102,500 to $204,500.The base pay offered will be determined on factors such as experience, skills, training, location, certifications, education, and any applicable minimum wage requirements. Decisions will be determined on a case-by-case basis. In addition to the base salary, this position may be eligible for performance-based incentives.
We are excited to offer a competitive total rewards package which includes health and welfare benefits, tuition assistance, 401K savings and other retirement programs as well as employee assistance programs.$116.2k - $229.1k
...Summary Join Deloitte’s Employer Health team as a Senior Consultant, Pharmacy Consulting, where you will advise employers and public-sector... ...to build and sustain professional relationshipsAbility to lead projects or workstreamsAbility to manage and prioritize...SuggestedContract workLocal areaVisa sponsorship- Omnicare, a leading provider of pharmacy services to long-term care facilities nationwide, seeks a seasoned compliance professional to strengthen... ...programmatic framework. You will oversee risk assessment, auditing, and monitoring activities, while navigating complex regulatory...Suggested
$92.4k - $138.5k
...™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single... ...for millions of Americans and proudly leading the next generation of care. To learn... ...) Position Summary The Pharmacy Audit Lead is a player-coach who performs pharmacy...SuggestedFull timeLocal areaFlexible hours- SmithRx is hiring for an onsite call center role in Lehi, UT. You will answer and resolve member inquiries, educate members on pharmacy benefits, and strive for one-call resolutions while upholding HIPAA standards. The position requires 2+ years of call center experience...SuggestedWork at officeRotating shift
- Humana invites you to join the CenterWell Pharmacy team as an Inbound Contacts Representative 1. You will address incoming inquiries by phone, chat, or written messages and perform essential administrative and customer support tasks while keeping member satisfaction at...SuggestedRemote jobFull timeWork at officeShift work
- CenterWell Pharmacy is seeking an Inbound Contacts Representative 1 to address member inquiries by phone, chat, or email. You will perform basic administrative and customer support tasks on routine, patterned assignments. This full-time, remote role requires Kentucky residency...Remote jobFull timeWork at officeShift work
$99k - $252.45k
...Financial Markets & Real Estate - General Corporate Real Estate Consultant - Manager, you will engage with clients to optimize their... ...guidance to support their business objectives. As a Manager, you will lead teams and manage client accounts, focusing on strategic...Full timeH1b$33.45 - $40.47 per hour
...represent TurboTax locally, serving as a fixture and public face of TurboTax in the community. \n Engage with new prospects, nurture leads, and convert prospects into long-term clients through proactive outreach. \n Lead and participate with the support of TurboTax in...Local area- ...WellDyne is seeking a customer service–oriented professional to act as the primary contact for pharmacy benefits inquiries and Rx order statuses. You will respond to incoming calls with professionalism and compassion, aiming to enhance customer satisfaction. The role...Work at office
- IQVIA is seeking a 100% remote Pharmacy Support Call Center Representative to join our team. You will handle payment assistance solutions, such as co-pay cards or vouchers, and support card activation, eligibility, and benefit explanations. The role requires Pharmacy Technician...Remote jobShift work
- VytlOne is seeking a Pharmacy Support Specialist for the Eastern US region, remote with 25% travel. The role focuses on training, documentation, helpdesk support, and Operations liaison while supporting multiple pharmacies within the network. Ideal candidates will have...Remote job
$75k - $85k
Company Overview: Strive Pharmacy is a personalized compounding pharmacy built on a simple conviction: medicine should fit the patient, not the other way around. We started Strive because we believed the pharmaceutical industry was overdue for a more human approach—one...Full timeLocal areaRemote workShift work- IQVIA is seeking a 100% remote Pharmacy Support Call Center Representative to assist patients, pharmacies, and healthcare professionals with program benefits, eligibility, and submissions. Responsibilities include handling calls, emails, or faxes, providing first-level...Remote jobHourly payFull timeContract work
- IQVIA is seeking a Pharmacy Support Call Center Representative for a 100% remote contract role. You will handle patient and provider inquiries, provide payment assistance such as co-pay cards, and explain program benefits and submission status. Responsibilities include...Remote jobContract workShift work
$18 per hour
IQVIA is seeking a Pharmacy Tech Support / Call Center Rep for 100% remote work from home. The role handles payment assistance solutions, such as co-pay cards, and supports patients, pharmacies, and medical professionals. The position requires a Pharmacy Technician background...Remote jobHourly payFull timeContract workWork from home- IQVIA is seeking a Pharmacy Support Call Center Representative to join our remote contract team. You will provide payment assistance solutions, such as co-pay cards or vouchers, and handle inquiries on card activation, eligibility, and benefits explanations. This role...Remote jobContract workShift work
- IQVIA is hiring a 100% remote Pharmacy Support Call Center Representative to provide payment assistance solutions such as co-pay cards or vouchers for patients, pharmacies and medical professionals. You will deliver first-level support by phone, email or fax, document...Remote job
- To provide responsive support to pharmacy customers, the remote Pharmacy Bot Support Specialist will manage day-to-day inquiries, troubleshoot issues related to automation, and collaborate with technical teams to ensure effective resolutions. Key Responsibilities Serve...Remote work
- Company Overview Founded in 2015, PHIL is a Series D health‑tech startup that is building a platform that interfaces between doctors, pharmacies, and patients to streamline the process of patients receiving prescriptions. This is a complex, archaic industry, and we've set...Work at officeRemote work
- ...provides inventory services to the healthcare delivery industry. They audit inventories of medical, surgical, and pharmaceutical products... .... The team is an extension of our customers' supply chain and pharmacy operations team. Compliance with our customers' requirements is...
$18 per hour
...we are looking for a 100% remote (work from home—WFH) contract Pharmacy Support Call Center Representative to join our team. In this position... ...the advancement of healthcare everywhere. #LI-DNP IQVIA is a leading global provider of clinical research services, commercial...Hourly payFull timeContract workPart timeImmediate startRemote workWork from homeWorldwideShift work- A leading investment firm in New York is seeking an Investor Relations Manager to manage communications with investors and prepare vital reports. The role involves supporting capital-raising efforts by coordinating investor outreach and presentations while ensuring alignment...
- ...be provided once you are selected and contacted. You will have the opportunity to help a top consulting company that will allow you to go beyond your accounting/auditing skills and help with multiple projects and a lot of top named clients. With multiple locations in...
- ...About Winona: Winona is one of the leading telemedicine companies providing HRT for women in menopause. We've built all of our technology... ...website, marketing technology etc. Winona has two compounding pharmacies and a team of in-house physicians providing world-class care...Full timeContract workFor contractorsCasual workRemote work
$120 per hour
...job Mercor connects elite creative and technical talent with leading AI research labs. Headquartered in San Francisco, our investors... ...Summers , and Jack Dorsey . Position: Finance operations / audit support Evaluator Type: Contract Compensation: $80–$1...Remote jobContract workSummer workWork at office- ...dynamic, entrepreneurial environment. Key Responsibilities Lead and support institutional fundraising initiatives across a... ...with pensions, endowments, foundations, family offices, RIAs, consultants, and other institutional allocators. Manage and contribute to...Full time
- AnewHealth is seeking a Pharmacy Technician to support patients, doctors, and facilities from a remote or office-based setting. You will handle prescription data, authorizations, and patient communications, ensuring accuracy and confidentiality. Ideal candidates have a...Remote jobWork at office
$72.8k - $130k
...outcomes by connecting people with the care, pharmacy benefits, data and resources they need... ...across all technology functions. They consult with users and technology specialists to... .../JDrawExperience in taking ownership or leading on assigned tasksProven communication...Remote jobMinimum wageFull timeWork experience placementWork at officeLocal area$110k - $140k
...The position is responsible for supporting the U.S. Audit Office in its mission to provide independent assessments of the Bank’s Information... ...report results of audit work in an effective and timely manner, leading to appropriate remedial action and ongoing management of risk....Full timeWork at office$59.7k - $74.6k
...their home. As the parent company of two leading brands, we bring over 50 years of experience... .... Assists tax leadership with tax audits by federal and state authorities. Supports... ...components including: insurance for medical/pharmacy, dental, vision, life, and disability, weight...Full timeFor contractorsWork at officeRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Pharmacy Audit Lead Consultant. Be the first to apply!
- external audit manager New York, NY
- pwc audit associate New York, NY
- internal audit associate New York, NY
- audit manager New York, NY
- audit supervisor New York, NY
- senior audit manager New York, NY
- audit director New York, NY
- audit associate New York, NY
- director internal audit New York, NY
- kpmg audit associate New York, NY




