Sr. Analyst, Pharmacy Managed Care & Clinical Services
Provide analytical support, development and oversight for Pharmacy Managed Care, Specialty, Pharmaceutical Manufacturer Programs and Clinical Services. This position is instrumental in developing, maintaining and delivering analytical solutions via performance reporting, risk and compliance assessments, and modeling the financial impact of third party reimbursement rate changes. The Senior Analyst will work closely with their direct supervisor, the Managed Care team, external/internal partners and executive leadership to support business initiatives, objectives and goals. This role requires a strong understanding of the direct and indirect components of the healthcare landscape with particular emphasis on the PBM industry and its business models, plan identification and reimbursement rate components. Key Competencies:
- Experience Required: 3+ years analytics experience
- Experience Desired: Advanced technical skills, manipulating large datasets using SQL;
- Experience Desired: Adapt at using Business Intelligence or other related Visualization tools to present complex data to leaders
- MUST HAVE: strong retail pharmacy and/or PBM industry acumen
- Education Desired: Bachelors Degree in Business, Finance, Analytics or related work experience
Job Responsibilities:
- Gather and present analytics from large data sets using SQL and visualization tools
- Perform detailed Third Party profitability and rate negotiation analytics including rate auditing, plan migration impacts, reimbursement trends and reconciliation chargebacks
- Translate business requirements into technical specifications, including data streams, integrations, transformations, databases, and data warehouses.
- Work directly with leadership team and end users to gather project data requirements, provide status updates, and deliver analytical solutions.
- Construct, manage, and maintain data pipelines from data sources into DW (data Warehouse) and design tables used for profitability analytics.
- Partner directly with the IT department on the implementation of data pipelines from source extracts into data warehouse.
- Report KPIs (key performance indicators) to measure the effectiveness of business decisions and program implementations.
- Identify additional data points and/or reporting needs for current projects to enhance operational decision making and project outcomes.
- Prepare financial data and provide short/long term profitability forecasting support
- Create, maintain, monitor, and ensure timely submission of manufacturer data feeds and invoices.