Pharmacy Audit Data Analyst (Healthcare)

Location: Remote anywhere in the US or onsite at the hirify.global office in San Diego, California. Must be legally authorized to work in the United States without current or future immigration sponsorship.

Salary: $59,200–$109,020 annually. For specified states and Washington, D.C., the range is $68,080–$109,020; for other locations, it is $59,200–$94,800.

Company

hirify.global is an independent professional services firm providing consulting and analytical solutions across healthcare, insurance, financial services, risk management, and data analytics.

What you will do

• Audit pharmacy claims against contractual pricing guarantees, dispensing fees, administrative fees, and other financial terms.
• Write, troubleshoot, and optimize SQL queries in SQL Server Management Studio for large claims datasets.
• Conduct rebate audits, including minimum guarantee reconciliations, pass-through testing, and rebate credit reviews.
• Translate client and PBM contracts into audit rules, exclusions, reporting requirements, and testable logic.
• Build data validation checks, design new audit tests, and contribute to automation and internal audit tools.
• Prepare client-ready reports and exhibits, explain findings, and support resolution of PBM responses and disputes.

Requirements

• Bachelor’s degree, preferably in mathematics, health, science, or business.
• 2–6 years of relevant experience in health insurance, pharmacy benefits, PBM operations, consulting, or related areas.
• Working knowledge of pharmacy benefit concepts, including copay and coinsurance structures, AWP pricing, MAC, drug classifications, formularies, and rebates.
• Demonstrated ability to write and troubleshoot SQL queries; SQL Server Management Studio experience is preferred.
• Proficiency with Excel, Word, and PowerPoint, including large datasets, plus strong analytical, documentation, communication, and problem-solving skills.
• US work authorization is required without current or future immigration sponsorship.

Culture & Benefits

• Remote work anywhere in the US or onsite work from the San Diego office.
• Skills training, career development, learning opportunities, mentoring, and employee resource groups.
• Medical, dental, and vision coverage, employee assistance, flexible spending accounts, and life and disability insurance.
• 401(k) matching and profit-sharing contributions, plus a discretionary bonus program.
• Paid time off, at least 10 paid holidays annually, and paid parental leave for eligible employees.