Audit Lead - Remote

Posted:
12/12/2025, 1:16:42 AM

Location(s):
Maryland, United States ⋅ Connecticut, United States ⋅ Colorado, United States ⋅ Massachusetts, United States ⋅ Hawaii, United States ⋅ Minnesota, United States ⋅ California, United States ⋅ Maine, United States ⋅ Washington, United States ⋅ Oregon, Illinois, United States ⋅ Illinois, United States ⋅ Vermont, United States

Experience Level(s):
Senior

Field(s):
IT & Security

Workplace Type:
Hybrid

Are you looking to accelerate your career without having to hide your authentic self - a place where you can be you? A career that’s making a bigger impact on the world?  At OneDigital, we are on a mission to help people do their best work and live their best lives.  From the services we offer to the way we show up for each other each day, we are fueling dreams, achieving big goals, and embracing each other’s truest selves.

We understand that pursuing a new job is a big deal.  Maybe you’re afraid you won’t fit in.  Well, here’s the good news.  For us, the days of “fit in to get in” are over and being different is not a barrier to getting ahead. Greatness comes in all shapes, sizes, colors, and experience levels. If you are looking for a people-first culture that is wired for growth, driven to serve, and totally committed to having your back, give us a shot. Your best life awaits.

Must be eligible to work in the United States without the need for work visa or residency sponsorship.

Our Newest Opportunity: 

Audit Lead Position Summary
The Audit Lead is a senior technical contributor within the RxConnection audit team. This role is not a managerial position, but it serves as a high-level resource for complex audits, workflow improvements, training, client support, and quality oversight. The Audit Lead works closely with Audit Leadership to ensure audit timelines, methodologies, and deliverables meet RxConnection’s quality standards and are communicated effectively to clients.
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Key Responsibilities:


Audit Execution & Technical Oversight
•    Lead the execution of complex PBM audits/reviews including: rebate, contractual guarantee audits, pricing validations, and ad hoc analyses.
•    Serve as a technical resource for SQL logic, pricing methodology, rebate constructs, and audit rule interpretation.
•    Conduct advanced variance analysis, trend identification, and root-cause investigations.
•    Ensure audit findings are accurate, defensible, and aligned with RxConnection’s methodology.

Coordination, Delivery & Client Presentation
•    Partner with Audit Leadership to build and maintain audit timelines and deliverables.
•    Assist with project management responsibilities, including tracking the progress, status, and deadlines of all active audit projects.
•    Coordinate internal audit tasks and monitor PBM data requests, follow-up items, and clarifications.
•    Identify and escalate risks or delays with recommended solutions.
•    Support the creation and review of audit reports, schedules, and client deliverables.
•    Present audit findings to clients, including explaining methodologies, variances, root-cause issues, and corrective action recommendations.
•    Participate in client calls, presentations, or follow-up discussions to ensure clear understanding of results.

Process Improvement
•    Evaluate current audit workflows, templates, methodologies, and data processes to identify efficiency and accuracy improvements.
•    Assist in developing and refining standard operating procedures (SOPs) for pharmacy and medical audits.
•    Participate in quality assurance reviews to ensure consistency and accuracy across audit engagements.
•    Contribute to innovation around automation, reconciliation logic, and repeatable audit processes.

Training & Mentorship
•    Provide guidance and coaching to Audit Analysts on contract interpretation, audit logic, data validation, and reconciliation workflows.
•    Assist in onboarding new Audit Analysts and developing training materials, step-by-step guides, and job aids.
•    Support team knowledge-sharing and help reinforce best practices across audit engagements.
•    Foster a collaborative environment that emphasizes accuracy, integrity, and continuous learning.
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Qualifications:

Required
•    3–6+ years of experience in PBM auditing, pharmacy benefits, claims analytics, or payment integrity.
•    Intermediate to advanced proficiency in SQL, Excel, and data analysis.
•    Strong understanding of PBM contract terms, rebate structures, pricing methods, and formulary dynamics.
•    Ability to interpret, operationalize, and audit PBM or carrier contract language.
•    Strong communication skills, including the ability to present complex audit findings clearly to clients.
•    Excellent organizational skills and comfort working in a fast-paced, deadline-driven environment.

Preferred
•    Experience with onsite rebate audits or combined medical + pharmacy audit review.
•    Exposure to Qlik, Power BI, or other BI/reporting tools.
•    Prior experience supporting training or workflow development.
•    Background in employer benefits, pharmacy operations, actuarial analysis, or health plan administration.

The typical base pay range for this role nationwide is $110,000 to $120,000 per year 

Your base pay is dependent upon your skills, education, qualifications, professional experience, and location. In addition to base pay, some roles are eligible for variable compensation, commission, and/or annual bonus based on your individual performance and/or the company’s performance.  We also offer eligible employees health, wellbeing, retirement, and other financial benefits, paid time off, overtime pay for non-exempt employees, and robust learning and development programs. You will receive reimbursement of job-related expenses per the company policy and may receive employee perks and discounts. 

To learn more, visit: www.onedigital.com/careers  

OneDigital is an equal opportunity employer. Not only as a matter of standard, but to honor and celebrate our differences. We believe that the power of ONE starts with you. We are committed to cultivating and preserving a culture that celebrates diversity, insists on equity and inclusion, and connects us. Ensuring our people feel seen, valued, respected, and supported is fundamental to our core values and business goals.

OneDigital provides equal employment opportunities to all employees and applicants for employment regardless of their: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy (including childbirth, lactation and related medical conditions), national origin or ancestry, citizenship or immigration status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law (collectively, “protected characteristics”). A copy of the Federal EEO poster is linked here.

Pursuant to local Fair Chance Ordinances, we will consider qualified applications with arrest or conviction records for employment. For applicable candidates, the following ordinances are linked here to inform you of your rights as an applicant:

City and County of San Francsico

City of Los Angeles

County of Los Angeles

Employment decisions shall comply with all other applicable federal, state and city/county laws prohibiting discrimination in employment. OneDigital complies with all criminal history inquiry [or ‘ban the box’] laws in California, Connecticut, Colorado, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington.

In short, we believe in hiring the most qualified applicant for the position, regardless of background.

If you have questions about our hiring policies and practices, we would be happy to discuss upon receiving your application. We hope to welcome you to OneDigital and look forward to hearing from you.

 

OneDigital understands the immense responsibility and opportunities provided by Artificial Intelligence. We utilize advanced Artificial Intelligence [AI] technologies to enhance our recruitment process. This includes using AI to filter candidates based on their qualifications and to rediscover potential candidates from our existing applicant pool. Our AI systems help us efficiently identify the best fit for our open positions, ensuring a streamlined and effective hiring experience. However, AI does not replace the humans in our process. If you have concerns about our use of AI, you may opt out where laws allow.

 OneDigital understands the immense responsibility and opportunities provided by Artificial Intelligence. We utilize advanced Artificial Intelligence [AI] technologies to enhance our recruitment process. This includes using AI to filter candidates based on their qualifications and to rediscover potential candidates from our existing applicant pool. Our AI systems help us efficiently identify the best fit for our open positions, ensuring a streamlined and effective hiring experience. However, AI does not replace the humans in our process. If you have concerns about our use of AI, you may opt out where laws allow.

Thank you for your interest in joining the OneDigital team!