Pharmacy Benefit Management (PBM) • Health Business Intelligence • Health Information Technology (HIT) • Medicare • Medicaid
501 - 1000
Yesterday
Pharmacy Benefit Management (PBM) • Health Business Intelligence • Health Information Technology (HIT) • Medicare • Medicaid
501 - 1000
• Design and develop data solutions - utilize data mining, data modeling, natural language processing, and machine learning to extract insights from large data sources. • Evaluate data scenarios through a product-oriented lens and deliver predictive models that inform business solutions as part of the drug value strategy portfolio. • Utilize data-oriented programming languages and visualization software to explore, analyze, and interpret large volumes of data in various forms and solve complex business problems. • Lead the development of analytic tools that will provide data reporting for our clients. • Develop and manage new and innovative specialty programs based on collaboration with the specialty network of pharmacies and track progress (partnerships (i.e. ROI, launch of initiatives, outreach, metric tracking, etc.) • Develop monthly and quarterly specialty spend reports to include initiatives, trends in the market, pipeline drugs, and other impactful events • Optimize and manage specialty claims auditing process (in conjunction with analytics team) • Drive generation of client-facing tools that help with feasibility, context, and budget and drug forecast models • Serve as a SME to the analytics team to develop complex reporting. • Other tasks and projects as needed
• Bachelor’s degree in business or related area of study, or equivalent combination of education and/or related work experience (In lieu of a degree, equivalent relevant experience may be considered.) • 8+ years of experience with working with healthcare data analytics (e.g. medical and pharmacy claims data) • 2+ years of experience with medical or pharmacy data in a health plan or pharmacy benefit manager (PBM). • Excellent written, interpersonal communication, and presentation skills, including ability to present complex technical concepts in a clear, concise manner to audiences with varying levels of technical understanding • Experience in Python, R, SQL, advanced statistical methods, and advanced proficiency to utilize data-oriented programming languages, statistical modeling, and visualization software (such as Tableau, PowerBI, etc.) • Experience with cloud-based data analysis (such as Snowflake) • Strong problem-solving skills in healthcare cost and utilization analysis • Experience in project management, KPI’s, and data visualization. • Experience managing key strategic initiatives in healthcare/PBM industry. • This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members. • This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).
• Flexible hybrid work model requiring on-site workdays (Puerto Rico Location Only) • Equal employment opportunities and prohibition of discrimination and harassment
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