Analyst, Client Audit and Performance

15 hours, 41 minutes ago
Full-time
Junior
Data Science and Analytics
Capital Rx

Capital Rx

Capital Rx provides comprehensive health benefit management and transparent pharmacy benefit management solutions, integrating various healthcare services to support millions of plan members across diverse sectors.

Health Care Providers & Services
251-1K
Founded 2017

Description

  • Research and analyze pharmacy claims to verify accuracy and contractual compliance across benefit setup, pricing, and guarantees
  • Perform audit risk assessments, annual logic reviews, and ongoing monitoring activities
  • Analyze, reconcile, and validate large datasets across multiple internal systems
  • Develop and maintain SQL and Python queries for audit reporting and performance monitoring
  • Create audit deliverable reports, quantify financial impact of potential and confirmed findings, and build dashboards to identify trends and risks
  • Identify and implement automation and process improvements across audit, reporting, and reconciliation workflows
  • Maintain and enhance code, reporting tools, and dashboards to improve reliability, efficiency, and scalability
  • Define and document technical requirements, data specifications, and methodologies to support transparency and repeatability
  • Collaborate with internal and technology teams to improve data quality, workflows, and controls, and provide ad-hoc analysis to support evolving business and audit needs
  • Ensure adherence to the Capital Rx Code of Conduct, including reporting noncompliance

Requirements

  • Bachelor’s degree in a quantitative or business-related field (e.g., Actuarial Science, Statistics, Economics, Finance, Data Analytics, Business Administration)
  • 2+ years of experience in data analytics, audit, or a related role
  • Experience in healthcare, PBM, or pharmacy claims; knowledge of pharmacy benefits, pricing, guarantees, and pharmacy claims analysis preferred
  • Proficiency with SQL (Snowflake preferred), Excel, and Tableau
  • Familiarity with Python and project management/version control tools (e.g., Jira, Confluence, GitHub)
  • Experience with audit testing, internal controls, risk assessment, and reconciling large datasets
  • Track record of leading cross-functional initiatives, meeting deadlines, and executing on deliverables
  • Strong attention to detail, intellectual curiosity, passion for continuous improvement, and ability to shift priorities and stay highly organized
  • Effective verbal and written communication with both technical and non-technical stakeholders

Benefits

  • Salary range: $80,000 — $100,000 USD
  • Opportunity to work on Judi’s enterprise health platform and with Capital Rx to impact pharmacy benefits and claims processes
  • Company commitment to a diverse workplace and equal employment opportunities
  • Flexible position description allowing management to assign or reassign duties to meet organizational goals

Interested in this position?

Apply directly on the company website

Apply Now

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