Pharmacy Auditor
US$65,000 – US$80,000 / yr base salary
Posted 25 Aug 2026
BranchFactor Summary
The original posting with the fluff stripped out
- Expected experience
- 2–5 yrs
- Management level
- Individual contributor
- Employment
- Hybrid
| Base salary | US$65,000 – US$80,000 / yr |
|---|
CertificationsCertified Pharmacy Technician (CPhT)
Field of studyAccounting, Business Administration, Finance, Healthcare Administration, Pharmacy (or related)
Study levelBachelor's
About Judi Health
Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing™ architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.
Location: Hybrid (Local to NYC, Denver or Charlotte areas)
Position Summary
The Pharmacy Auditor is responsible for conducting comprehensive audits of network pharmacies to ensure compliance with contractual obligations, regulatory requirements, client expectations, and industry standards. This role evaluates the accuracy of pharmacy claims, prescription dispensing practices, inventory records, and supporting documentation to identify billing discrepancies, recover overpayments, and promote program integrity.
The Pharmacy Auditor plays a critical role in safeguarding healthcare resources by identifying operational, billing, and compliance risks within the pharmacy network. This position collaborates closely with Compliance, Legal, Finance, Provider Relations, Clinical, and Fraud, Waste, and Abuse (FWA) teams to support corrective actions, recoveries, regulatory requirements, and education initiatives.
Position Responsibilities:
- Conduct desk, remote, and on-site pharmacy audits to evaluate pharmacy compliance with contractual, regulatory, and operational requirements.
- Review prescription records, claims data, purchase invoices, inventory documentation, dispensing logs, and other supporting records to validate the accuracy and legitimacy of billed claims.
- Analyze pharmacy claims and utilization data to identify potential discrepancies, billing irregularities, overpayments, and areas of non-compliance.
- Calculate and document audit findings and financial recoveries in accordance with established audit methodologies, client requirements, and applicable laws and regulations.
- Prepare clear, accurate, and comprehensive audit reports outlining findings, root causes, financial impact, and recommended corrective actions.