Pharmacy Business Intelligence Engineer

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Health Insurance • Managed Care • TPA Services • Pharmacy Benefit Management • Third Party Administrator

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Description

• Design and build a health plan as a Pharmacy Business Intelligence Engineer. • Collaborate with Directors across product, operations, medical management, and provider contracting. • Ensure data accuracy and develop analytic processes and procedures. • Interpret data findings using advanced data modeling and analytical techniques.

Requirements

• Bachelor’s Degree in Business Administration, Mathematics, Computer Science, Statistics, Information Systems, or a related field • Five (5) years' experience in quantitative analytics and conducting advanced analytic modeling for large pharmacy and clinical datasets. • Three (3) years of experience working with claims data to evaluate reimbursement changes, payment discrepancies, medical expense opportunities, quality outcomes and risk • Master’s Degree in Business Administration, Computer Science, Statistics, Information Systems, or a related field • Three (3) years of experience working with Medicare and/or Medicaid Data • Understanding of Medicare and/or Medicaid Regulatory Reporting, e.g., WV Department of Insurance, Department of Medicaid/Health Services and CMS