Pharmacy Benefits Audit Operations Analyst

Summary

Milliman provides consulting and analytical services across healthcare, employee benefits, risk management, and related industries. The Pharmacy Benefits Audit Operations Analyst will support multiple audit and consulting engagements by analyzing pharmacy data, coordinating project activities, managing data requests, and reviewing deliverables for client release.

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

Skills

• Bachelor's degree or equivalent combination of education and experience
• 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
• 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
• 2+ years of relevant experience in data analysis, project management, consulting, or a related field
• Pharmacy benefits or PBM industry experience
• PMP, CAPM, or pharmacy-specific credentials (e.g., CPhT)
• Familiarity with claims data or basic SQL

Qualifications

Must Haves

• Bachelor's degree or equivalent combination of education and experience
• 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
• 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

Nice to Haves

• 2+ years of relevant experience in data analysis, project management, consulting, or a related field
• Pharmacy benefits or PBM industry experience
• PMP, CAPM, or pharmacy-specific credentials (e.g., CPhT)
• Familiarity with claims data or basic SQL

Benefits

• This position may be performed remotely.
• Milliman invests in skills training and career development and gives all employees access to a variety of learning and mentoring opportunities.
• 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.