Pharmacy Claims and Rebates Audit Consultant

About the role

Marsh's Health & Benefits team within its People and Investments business is looking for a Pharmacy Claims and Rebates Audit Consultant. The role can be based near any of the US offices and is hybrid, with at least three days a week in the office. It leads complex pharmacy claims and rebate audits from planning through to the final report, acting as the primary consultant and subject-matter expert for clients.

Key responsibilities

• Lead end-to-end pharmacy claims and rebate audits for complex, high-visibility clients, identifying mispriced, misadjudicated or out-of-contract claims.
• Translate PBM contracts, pricing guarantees, formulary terms and rebate agreements into audit scope and sample selection using analytics and SaaS tools.
• Oversee claim and rebate review activity, ensuring consistent methodology, sound judgment and clear documentation.
• Quantify financial impact, evaluate vendor responses and drive issues to resolution.
• Serve as primary client contact, presenting methodology, findings and recommendations.
• Partner with internal consultants, mentor team members and act as a quality checkpoint.
• Identify opportunities to expand services and support new business development.

Required profile

• Bachelor's degree in pharmacy, healthcare, business, finance, analytics or a related field.
• At least 8 years of experience in pharmacy claims auditing, PBM operations, pharmacy benefit consulting or health plan administration.
• Excellent knowledge of pharmacy benefits, claims adjudication, formulary administration and specialty pharmacy.
• Strong knowledge of PBM contract terms, pricing methodologies and rebate structures.
• Client-facing consulting experience and ability to partner with internal consultants.
• Nice to have: advanced degree, PharmD, RPh, MBA, CPA or similar credential; experience with specialty pharmacy, Medicare Part D or PBM financial audits; experience managing or supervising staff.

What we offer

• Base salary range of $102,500 to $204,500, depending on experience, skills, location and other factors.
• Performance-based incentives may apply.
• Health and welfare benefits, tuition assistance, 401K and other retirement programs, and employee assistance programs.