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Remote Pharmacy Audit Analyst Jobs (NOW HIRING)

Qode

Remote Pharmacy Technician

CO · On-site +1

$18 - $45/hr

... remote Pharmacy Technician role. Whether you're starting your career or bringing years of ... Develop and optimize workflows for pharmacy data management Perform detailed data analysis and ...

Centene

Pharmacy Technician

$19.43 - $32.98/hr

Uses reports to perform audits and quality checks on the current formulary status for accuracy and ... with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an ...

Adecco

Remote Pharmacy Technician

Minneapolis, MN · Remote

$22.65 - $25.65/hr

Adecco Healthcare & Life Sciences is hiring Remote Pharmacy Technicians ! This role is work from ... analytical formulas (VLOOKUP, if) · Ability to work between the hours of 7 AM - 7:00 PM, CST and ...

Onco360

Pharmacy Compliance Analyst

Woodridge, IL · Remote

Remote opportunity! Some Travel required - see details below. The right candidate will live within ... Also, the Compliance Analyst will assist with the Onco360/CareMed/ConnectMed360 audit and ...

Gallagher

Consultant, Pharmacy Auditor

Richmond, VA · Remote

... audit team as necessary. * Assist with claims data analysis and quality assurance as requested ... Strong background in pharmacy benefit management (PBM) processes and systems. * Extensive ...

Onco360

Pharmacy Compliance Analyst

New Hyde Park, NY · Remote

Remote opportunity! Some Travel required - see details below. The right candidate will live within ... Also, the Compliance Analyst will assist with the Onco360/CareMed/ConnectMed360 audit and ...

Onco360

Pharmacy Compliance Analyst

Houston, TX · Remote

Remote opportunity! Some Travel required - see details below. The right candidate will live within ... Also, the Compliance Analyst will assist with the Onco360/CareMed/ConnectMed360 audit and ...

Onco360

Pharmacy Compliance Analyst

Buffalo, NY · Remote

Remote opportunity! Some Travel required - see details below. The right candidate will live within ... Also, the Compliance Analyst will assist with the Onco360/CareMed/ConnectMed360 audit and ...

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Remote Pharmacy Audit Analyst information

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$89.7K

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How much do remote pharmacy audit analyst jobs pay per year?

As of Sep 8, 2026, the average yearly pay for remote pharmacy audit analyst in the United States is $89,650.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,500.00 and $116,500.00 per year, depending on experience, location, and employer.

What is a remote pharmacy audit analyst?

A Remote Pharmacy Audit Analyst is a professional who reviews pharmacy claims and records to ensure compliance with regulations and contractual requirements. Working remotely, they analyze data, identify discrepancies or fraud, and prepare reports for pharmacy benefit managers, insurance companies, or healthcare organizations. Their role is crucial in detecting billing errors, preventing fraud, and ensuring pharmacies adhere to best practices. Strong analytical skills, attention to detail, and knowledge of pharmacy operations are essential for this position.

How does a remote pharmacy audit analyst typically collaborate with pharmacies and internal teams to resolve audit discrepancies?

As a Remote Pharmacy Audit Analyst, you will frequently interact with both external pharmacy partners and internal audit or compliance teams to clarify and resolve discrepancies identified during audits. This often involves reviewing documentation, communicating findings, and providing detailed explanations or requests for additional information. You may participate in virtual meetings, manage documentation through secure platforms, and work closely with team members to ensure compliance standards are met. Strong communication and organizational skills are key to efficiently managing these collaborations while working remotely.

What are the key skills and qualifications needed to thrive as a remote pharmacy audit analyst, and why are they important?

To thrive as a Remote Pharmacy Audit Analyst, you need a solid understanding of pharmacy operations, claims processing, and healthcare compliance, often supported by a degree in pharmacy, healthcare, or a related field. Familiarity with pharmacy benefit management (PBM) systems, auditing software, and relevant certifications like Certified Pharmacy Technician (CPhT) are typically required. Strong attention to detail, analytical thinking, and effective communication are soft skills that help you identify discrepancies and collaborate with stakeholders. These skills are essential for ensuring regulatory compliance, minimizing financial risk, and maintaining the integrity of pharmacy operations in a remote environment.

What is the difference between Remote Pharmacy Audit Analyst vs Remote Pharmacy Claims Reviewer?

AspectRemote Pharmacy Audit AnalystRemote Pharmacy Claims Reviewer
Required CredentialsPharmacy or healthcare-related certifications, auditing experiencePharmacy technician license, claims processing knowledge
Work EnvironmentRemote, healthcare or insurance companiesRemote, insurance companies or pharmacy benefit managers
Employer & Industry UsageInsurance firms, healthcare providers, auditing firmsInsurance companies, pharmacy benefit managers, healthcare organizations

Both roles are remote positions within the healthcare and insurance industries, requiring knowledge of pharmacy operations. The Pharmacy Audit Analyst focuses on auditing pharmacy claims for compliance and accuracy, often requiring certifications and auditing experience. The Pharmacy Claims Reviewer primarily reviews claims for correctness and eligibility, typically needing pharmacy technician credentials. While both roles are similar, the Audit Analyst emphasizes compliance and auditing processes, whereas the Claims Reviewer concentrates on claims validation and processing.

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Remote Pharmacy Audit Analyst jobs near you
Infographic showing various Remote Pharmacy Audit Analyst job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 69% Full Time, 28% Part Time, and 2% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $89,650 per year, or $43.1 per hour.

Pharmacy Claims Auditor Sr - Remote

Prime Therapeutics LLC

Albuquerque, NM • On-site, Remote

$59K - $94K/yr

Full-time

Posted 7 days ago

Prime Therapeutics rating

7.9

Company rating: 7.9 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

16th of 113 rated pharmacies

Job description

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Pharmacy Claims Auditor Sr - RemoteJob Description
The Senior Pharmacy Claims Auditor is responsible for providing education, training and guidance to identify and evaluating potential waste and compliance through the pharmacy audit process. This position leads the development and enhancement of audit tools, analytics, processes, and training to effectively identify erroneous claims, non-compliant pharmacy practices or potential improper pharmacy reimbursements. This role will execute and support audit-related initiatives, leveraging best practices to identify emerging audit trends and uncover business value opportunities for Prime and its clients.
Responsibilities
  • Collaborate with cross-functional teams to identify, develop, deliver, and support training focused on trend analysis, audit planning, procedures, and system process, along with identifying technology enhancement opportunities
  • Provide guidance and operational support to the Pharmacy Audit Operations team, promoting best practices, leading projects, and resolving issues
  • Analyze claim and audit data to support ongoing audit analytic efforts, identify trends and refinements; collaborate with other department staff to create enhanced reporting and represent audit team as the Subject Matter Expert (SME) for system enhancement initiatives and testing
  • Other duties as assigned

Minimum Qualifications
  • Bachelor's degree in Health Science or related area of study, or equivalent combination of education and related work experience; HS diploma or GED is required
  • 5 years of work experience in retail, long term care, specialty, home infusion, or mail order pharmacy or combined pharmacy and Pharmacy Benefit Management experience to include 3 years of work experience in audit or quality assurance
  • National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
  • Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications
  • Change agile; willing and able to adjust individual and team direction based upon changing priorities and business need while working with a high degree of autonomy
  • Ability to think critically, problem solve and use appropriate judgement to make decisions and provide risk advice to internal and external partners while anticipating the broad impact of decisions
  • Ability to establish trust, respect and credibility and form effective working relationships with individuals at all levels of an organization; collaborate effectively cross-functionally and with clients and other key stakeholders
  • Ability to distill complex concepts or situations into concise and compelling communications
  • Ability to effectively de-escalate potentially confrontational situations
  • Proficiency in MS Word, Excel, and database software
  • Demonstrated skill and understanding of the point of sale and on-line pharmacy claims processing environment

Preferred Qualifications
  • 5 years of previous audit experience
  • Current Registration with State Board of Pharmacy in the state where position is located
  • Previous PBM experience

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $59,000.00 - $94,000.00 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.

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About Prime Therapeutics

Sourced by ZipRecruiter

Prime Therapeutics, located in Eagan, MN, is a pharmacy benefits management company that has been serving the healthcare industry since its foundation. They are an integral participant in the medical sector, specifically in the realm of health insurance. They focus on providing innovative pharmacy benefits and services to more than 30 million members nationwide. Besides their main pharmacy benefit management, they offer mail service pharmacy, specialty pharmacy, benefits management, and consultative engagement services to ensure individuals have continuous access to affordable prescription drugs. Prime Therapeutics, founded around three decades ago, has grown to stand out as a leader in its industry, thanks to its commitment to improving the health of its clients.

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Eagan, MN, US

Year founded

1987

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