Pharmacy Benefits Audits and Analytics Consultant
Are you passionate about delivering trusted advice that improves lives?
Come work with us!
Our Consultant, Pharmacy Benefit Claims Audits and Analytics has responsibility for leading pharmacy benefits claims audits and analyses for our clients.
Key Responsibilities:
β’ Perform as the lead pharmacy claims audit consultant and/or CRM to clients.
β’ Provide strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.
β’ Conduct planning meetings to identify/define client needs/issues and develop project plans and approaches that are responsive to client needs.
β’ Conduct technical analyses and quality reviews. Formulate conclusions and deliver client recommendations.
β’ Build and maintain effective rapport internally and with senior management in client organizations, vendors, and internally within the Company.
β’ Manage projects within scope, profitability and productivity targets.
β’ Lead business growth strategies and marketing initiatives to assist business development and cross-selling efforts.
β’ Respond to Requests For Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.
β’ Gather, use and share market intelligence to develop and introduce unique and/or new approaches to servicing clients.
Qualifications
β’ 6+ years of pharmacy or health claims audit and/or administration experience to include significant exposure to and expertise in electronic audit functions to include systems and tools relevant to an independent/third-party audit process; experience leading efforts to achieve revenue and/or profitability-oriented objectives; actuarial experience valued.
β’ Undergraduate degree. Advanced degree preferred.
β’ Proficiency in Microsoft suite of products (i.e., Word, Excel, PowerPoint, and Outlook).
β’ Data analysis expertise to include familiarity with SQL and Excel macros highly preferred.
β’ Project management and client servicing/relationship management skills.
β’ Effective interpersonal and relationship building skills with ability to build rapport with diverse audiences.
β’ Proficiency in writing and oral presentation. Strong ability to problem solve, multi-task and manage multiple deadlines.
Join Segal:
If your qualifications align closely with what we have described, we encourage you to apply. Your unique background and skills matter because at Segal, we believe that different experiences and perspectives drive innovation and excellence. We are committed to creating a fair and transparent hiring process and all hiring decisions will be merit driven. If you require accommodation during the interview, please let us know. Thank you for considering Segal. We are excited to learn more about you!
About Segal and its Total Rewards Program:
Segal is a privately owned, leading North American employee benefit, human resources and investment management consulting firm with over 80 years of history providing trusted advice that improves lives. Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.
Segalβs total rewards are part of what makes Segal a special place to work. The current salary range for this position is $101,500 - $130,000.
#LI-Remote
Primary Location: US-IL-Chicago
Other Locations: US-AZ-Tempe, US-MA-Boston, US-DC-Washington, US-CA-Los Angeles, US-CA-San Francisco, US-TX-Houston, US-NY-New York
Work Locations: Chicago 101 North Wacker Drive, Suite 1800 Chicago 60606
Job: Consulting - Non-Actuarial Benefits
Organization: SP - Benefit Audit Solutions
Schedule: Regular
Regular Employee
Employee Status: Experienced Level
Job Type: Full-time
Travel: Yes, 25 % of the Time
Job Posting: Apr 1, 2026, 8:20:22 AM
Apply tot his job
Apply To this Job
Come work with us!
Our Consultant, Pharmacy Benefit Claims Audits and Analytics has responsibility for leading pharmacy benefits claims audits and analyses for our clients.
Key Responsibilities:
β’ Perform as the lead pharmacy claims audit consultant and/or CRM to clients.
β’ Provide strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.
β’ Conduct planning meetings to identify/define client needs/issues and develop project plans and approaches that are responsive to client needs.
β’ Conduct technical analyses and quality reviews. Formulate conclusions and deliver client recommendations.
β’ Build and maintain effective rapport internally and with senior management in client organizations, vendors, and internally within the Company.
β’ Manage projects within scope, profitability and productivity targets.
β’ Lead business growth strategies and marketing initiatives to assist business development and cross-selling efforts.
β’ Respond to Requests For Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.
β’ Gather, use and share market intelligence to develop and introduce unique and/or new approaches to servicing clients.
Qualifications
β’ 6+ years of pharmacy or health claims audit and/or administration experience to include significant exposure to and expertise in electronic audit functions to include systems and tools relevant to an independent/third-party audit process; experience leading efforts to achieve revenue and/or profitability-oriented objectives; actuarial experience valued.
β’ Undergraduate degree. Advanced degree preferred.
β’ Proficiency in Microsoft suite of products (i.e., Word, Excel, PowerPoint, and Outlook).
β’ Data analysis expertise to include familiarity with SQL and Excel macros highly preferred.
β’ Project management and client servicing/relationship management skills.
β’ Effective interpersonal and relationship building skills with ability to build rapport with diverse audiences.
β’ Proficiency in writing and oral presentation. Strong ability to problem solve, multi-task and manage multiple deadlines.
Join Segal:
If your qualifications align closely with what we have described, we encourage you to apply. Your unique background and skills matter because at Segal, we believe that different experiences and perspectives drive innovation and excellence. We are committed to creating a fair and transparent hiring process and all hiring decisions will be merit driven. If you require accommodation during the interview, please let us know. Thank you for considering Segal. We are excited to learn more about you!
About Segal and its Total Rewards Program:
Segal is a privately owned, leading North American employee benefit, human resources and investment management consulting firm with over 80 years of history providing trusted advice that improves lives. Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.
Segalβs total rewards are part of what makes Segal a special place to work. The current salary range for this position is $101,500 - $130,000.
#LI-Remote
Primary Location: US-IL-Chicago
Other Locations: US-AZ-Tempe, US-MA-Boston, US-DC-Washington, US-CA-Los Angeles, US-CA-San Francisco, US-TX-Houston, US-NY-New York
Work Locations: Chicago 101 North Wacker Drive, Suite 1800 Chicago 60606
Job: Consulting - Non-Actuarial Benefits
Organization: SP - Benefit Audit Solutions
Schedule: Regular
Regular Employee
Employee Status: Experienced Level
Job Type: Full-time
Travel: Yes, 25 % of the Time
Job Posting: Apr 1, 2026, 8:20:22 AM
Apply tot his job
Apply To this Job