Description
Ready to join an established leader whose trusted advice improves lives around the globe?
Segal is a place where flexible work is embraced and career development is enthusiastically supported.
The Associate Consultant, Pharmacy Benefit Claims Audits and Analytics has responsibility for conducting and managing claims audits within the Segal Benefit Audit Solutions (BAS) Practice.
Primary Job Responsibilities:
* Performs as a pharmacy benefit claims audits and analytics consultant and/or CRM on select clients.
* Conducts and manages pharmacy benefits claims audit projects within scope, profitability and productivity targets.
* Support business growth strategies and marketing initiatives to assist Leaders in business development and cross-selling efforts. Contribute to the continual development of resources, efficiencies and quality.
* Responds to Requests For Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.
* Gathers, uses and shares market intelligence to develop and introduce unique and/or new approaches to servicing clients.
* Conducts planning meetings to identify/define client needs/issues and develops project plans and approaches that are responsive to client needs.
* Coordinates and conducts technical analyses and quality reviews on work done within the team.
* Builds and maintains effective rapport internally and with senior management in client organizations.
* Provides strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.
* 4 years of pharmacy benefit claims administration and/or audit experience to include significant exposure to tools relevant to an independent/third-party audit process.
* Undergraduate degree. Advanced degree preferred.
* Previous Pharmacy Claims Auditing, Pharmacy Benefits Contracting, and/or Claims Processing experience preferred.
* Knowledge and familiarity with SQL.
* Demonstrated project management and client servicing/relationship management skills.
* Demonstrated experience setting and leading efforts to achieve revenue and/or profitability- oriented objectives with desired results.
* Effective interpersonal and relationship building skills with ability to build rapport with diverse audiences.
* Experience with SQL or Python highly preferred.
Diversity, Equity and Inclusion at Segal:
At Segal, we are committed to a culture of diversity, equity and inclusiveness, as demonstrated through our recruitment, retention and employee development programs. We maintain an environment that respects and builds on the assets and talents of each person, valuing their differences. We also engage in good faith efforts to maintain an environment free from discrimination and harassment in strict compliance with applicable laws, and consider all qualified candidates for employment without regard to their race/ethnicity, national origin, color, religion, gender, sexual orientation, gender identity or expression, age, disability or medical condition, protected veteran or military status, criminal record history, marital status, or status in any group or class protected by applicable federal, state or local law. We also engage in affirmative action to employ and advance in employment qualified women, minorities, disabled individuals and protected veterans. Maintaining a diverse, equitable and inclusive workforce is a win/win, and provides Segal with the opportunity to leverage our top talent to provide innovative solutions to our clients.
