Pharmacy Benefit Analyst

Minimum of 3 to 5 years of experience in pharmacy benefit analytics, auditing, or a related role within the PBM or healthcare industry Proficiency in Microsoft Excel (pivot tables, formulas, charts) Proficiency in Microsoft Access (queries, data relationships) Experience working with large healthcare datasets, including pharmacy claims data Familiarity with pharmacy claims adjudication systems and PBM pricing models (preferred) Strong analytical and critical thinking skills Ability to translate data into actionable insights Ability to work independently in a remote, fast-paced environment with minimal supervision Excellent verbal and written communication skills Working knowledge of rebate contracts, discount guarantees, and performance metrics in the pharmacy benefit space (preferred) Experience presenting analytical findings to internal and external stakeholders (preferred) Knowledge of healthcare regulations, including HIPAA and transparency regulations (preferred)

Produce savings analyses comparing PBM offers Perform RFP analyses and prepare reports Model plan designs for clients Download and manage reports using automated tools Conduct ad hoc analyses Generate KPI, plan performance, and ad hoc reports using claims data Perform reconciliations (discount, dispensing fee, rebate guarantees, claims repricing) Assist consultants with claims data review and plan performance monitoring Review and help present findings to stakeholders Monitor discount and rebate guarantees Maintain monthly, quarterly, and annual reports Communicate updates via email, video conference, and phone calls