Director - PBM Contract Audit

March 25

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Pharmaceutical Strategies Group - PSG

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Pharmaceutical Strategies Group - PSG is a company that specializes in optimizing pharmacy programs to unlock maximum cost savings and produce extraordinary outcomes. As part of the EPIC company, PSG serves to navigate the complex and ever-changing landscape of drug cost management. They provide pharmacy benefits consulting, clinical optimization, audits, and other specialized services to employers, health plans, and other organizations. The company is renowned for its data-driven insights and research, using their Artemetrx analytics platform to drive financial results and enhance program performance. PSG strongly advocates for their clients, providing independent and transparent advisory services dedicated to optimizing pharmacy operations and benefits. With over 30 years of pharmacy advocacy experience, they focus on delivering custom solutions and data-backed insights to help clients manage costs effectively and efficiently.

Pharmacy Benefit and PBM Consulting • Clinical Consulting • Auditing • Data Warehousing & Analytics • Specialty Pharmacy Solutions

51 - 200 employees

Founded 2003

⚕️ Healthcare Insurance

💊 Pharmaceuticals

📋 Description

• For over 30 years PSG has been singularly focused on helping our clients navigate the complex and ever-changing challenges of drug management. • The Director of Audit Services will be responsible for establishing strategic direction and for the leadership, development, and production of PSG audit services. • The Director oversees the development of audit work plans, tools, and methodologies and for the execution of financial, operational and compliance audits specific to pharmacy management services on behalf of PSG clients. • A high attention to detail and process will be critical for success. • The Director will be someone that is self-directed and thrives in managing timelines in a fast-paced environment. • Experience and comfort working with clients and vendors is a must as this role will require interaction with various stakeholders, including those in executive-level positions.

🎯 Requirements

• Bachelor’s degree in Business, Finance, or a health-related field • 5 years of leadership experience • At least 7 years of either a) pharmacy benefit audit or b) claim adjudication research experience on one or more PBM platforms • Working knowledge of the PBM industry and pharmacy benefit claims • Proficient in Microsoft Office, with extensive experience working with Excel • Proficient in SQL to extract data and build queries • Ability to effectively develop and maintain strong working relationships with internal and external stakeholders • Strong written and verbal communication skills and discipline to multitask and prioritize projects to meet scheduled deadlines • Strong analytical, problem-solving, organization, critical thinking, and time management skills • Excellent attention to detail and quality • Previous Medicare Part D experience preferred • Ability to interact with diverse group of stakeholders including executives, managers, clients, and subject matter experts both technical and non-technical • Solid, independent worker (work from home) • Ability for some travel (5% - 10%)

🏖️ Benefits

• Generous Paid Time off • Generous leave time options: Paid parental leave, pregnancy disability and bonding leave, and organ donor/bone marrow donor leave • Generous employee referral bonus program of $1,500 per hired referral • Employee recognition programs for demonstrating EPIC’s values plus additional employee recognition awards and programs (and trips!) • Employee Resource Groups: Women’s Coalition, EPIC Veterans Group • Professional growth & development: Mentorship Program, Tuition Reimbursement Program, Leadership Development • Unique benefits such as Pet Insurance, Cancer Insurance, Identity Theft & Fraud Protection Coverage, Legal Planning, Family Planning, and Menopause & Midlife Support • Additional benefits include (but are not limited to): 401(k) matching, medical insurance, dental insurance, vision insurance, and wellness & employee assistance programs • 50/50 Work Culture: EPIC fosters a 50/50 culture between producers and the rest of the business, supporting collaboration, teamwork, and an inclusive work environment. It takes both production and service to be EPIC! • EPIC Gives Back – Some of our charitable efforts include Donation Connection, Employee Assistance Fund, and People First Foundation • We’re in the top 10 of property/casualty agencies according to “Insurance Journal”