The Pharmacy Data Analyst supports Pharmacy Services by analyzing data from multiple sources, identifying trends, and generating business insights to improve health and financial outcomes for the plan's members. This role also supports plan benefit management and coding across multiple lines of business within the pharmacy benefit adjudication platform.
Key responsibilities include:
- Integrating data from multiple sources to produce data elements that support continuous quality improvement.
- Assisting pharmacy team members with complex data projects.
- Analyzing data accuracy and recommending improvements to data collection and reporting processes.
- Identifying data quality issues and working with internal and external partners to resolve them.
- Preparing data and presentations for management, committees, and other stakeholders.
- Reconciling daily eligibility file reports with PBM data and ensuring alignment with HEDIS measures.
- Calculating client drug price guarantees, admin fees, rebates, and related contract terms.
- Reviewing PBM compliance files, assisting with report development, testing files, and configuring data in mapping tools.
- Creating and maintaining executive management dashboards for pharmacy funds, drug spend, rebates, savings, and related metrics.
- Assisting with auditing PBM plan benefit coding and plan materials.
- Supporting updates to benefit materials for internal and external teams.
- Creating and recording impact reports from internal audit findings and coordinating corrective actions with PBM partners.
Schedule: 8:00am - 5:00pm, 40 hours per week.
Requirements & Qualifications
Required Qualifications
- Bachelor's or master's degree related to data analytics, or at least 1 year of experience in pharmacy and medical claim data reporting.
- Proficiency in Microsoft Excel, including pivot tables, graphing, and complex formulas.
- Experience with data collection, analysis, and visualization methods.
- Working knowledge of quality improvement principles, theory, study design, and statistical modeling.
- Ability to multitask, adapt to changing processes, and work in a fast-paced environment.
- Self-motivated, goal-oriented, and able to work independently and as part of a team.
- Proficient keyboarding skills and computer literacy with the ability to navigate multiple systems.
- Ability to exercise independent judgment and use relevant information in decision-making.
Desired Qualifications
- Excellent oral, written, telephonic, and interpersonal skills.
- Working knowledge of the PBM industry and pharmacy benefit claims.
- Certified Pharmacy Technician (CPhT).
- Experience building automated reports, self-service tools, and dashboards in PowerBI.
- Strong mathematical problem-solving and graphing skills.
- Intermediate to proficient SQL skills for data extraction.
- Prior experience in a PBM environment, health plan, or managed care service organization.
Location
West Virginia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago