Job Description:
• Oversees all aspects of pharmacy contractual guarantees, including routine performance analysis and pharmacy pricing recommendations to help meet guarantee targets.
• Manages provider contracts end to end and support cross-functional partners with future-period negotiations and in-period performance inquiries.
• Leads or contributes to complex projects and analyses, applying sound judgment, creativity, and strategic thinking to plan and deliver initiatives.
• Presents findings and recommendations to leadership, helps enhance financial analysis and forecasting methods, translates business needs into technical specifications for matrix partners, and serves as an internal subject matter expert.
• Manage pharmacy pricing to meet contractual guarantee targets.
• Review pharmacy contracts to ensure all guarantees are accurately captured.
• Track, manage, and report pharmacy guarantee performance.
• Recommend system adjustments to align with provider contractual guarantees.
• Monitor and optimize the provider guarantees database.
• Provide cross-functional support to internal business partners through ad hoc projects.
• Lead claims data analyses to evaluate strategic corporate initiatives and projects.
• Analyze current processes and identify improvement opportunities.
Requirements:
• Bachelor’s degree required, preferably in business, accounting, mathematics, statistics, or finance.
• 3+ years of experience in business analysis, modeling, pricing, and/or data management.
• Proficiency in SQL and Microsoft Office applications.
• Experience with data warehouses and coding is preferred, including Visual Basic, Python, C++, R, or Teradata.
• Strong understanding of the PBM business model.
• Strong analytical and organizational skills, with the ability to work independently, manage multiple priorities, meet deadlines, and maintain attention to detail.
• Excellent Communication skills, oral and written.
• Capability to prepare and present concepts and proposals to all levels of management.
Benefits:
• medical, vision, dental, and well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays