Teams at Milliman

Analyzes pharmacy claims, rebates, financial guarantees, and PBM contracts using SQL and large datasets. Translates contract terms into audit rules, performs validation and rebate testing, develops audit logic, prepares client-ready reports, investigates disputes, communicates findings, and supports process improvements and automation. Requires pharmacy benefits or health insurance knowledge, strong analytical skills, and the ability to explain technical findings to clients and vendors.

Analyzes and validates pharmacy claims, eligibility, rebate, and pricing data using Excel and SQL. Supports more than 20 concurrent audit and consulting engagements by managing data requests, schedules, deliverables, client communications, working sessions, workload tracking, and quality reviews. Collaborates with clients, PBMs, administrators, carriers, and vendors to resolve issues, monitor deadlines, and prepare audit exhibits and reports for consultant and client review.

Develop and deploy traditional machine learning, GenAI, and NLP solutions for healthcare, insurance, and life sciences applications. Responsibilities include model research, validation, documentation, deployment, maintenance, experimentation, and collaboration with product, business development, ML engineering, and IT teams. The role also contributes to data science best practices, internal tooling, peer review, coaching, and translating client analytical needs into commercially viable products.