Analyst, Payor Operations and Solutions

Walgreens; Deerfield (IL); On-site; USD 65,000 - 114,000; Full time

Job summary

Walgreens is seeking an analytical professional to analyze data supporting proposals and contracts for pharmacy programs. You will evaluate pricing, portfolio profitability, and regulatory impacts to guide strategy and compliance across third-party plans.

The role involves developing financial models, preparing reports, and presenting findings to management to drive competitive and compliant outcomes for Walgreens.

Qualifications

• Bachelor's degree OR High School Diploma / GED with at least 3 years of healthcare industry experience.
• Experience analyzing and reporting data to identify issues, trends, or exceptions to drive improvement.
• Strong time management to handle multiple projects and deadlines.
• Experience providing customer service to internal and external customers and meeting quality standards.
• Intermediate Excel skills (formulas, formatting, charts).
• Experience with PowerPoint and Word for presentations and reports.
• Understanding of project management and lean methodologies.
• Willing to travel up to 10% of the time for business purposes.

Responsibilities

• Creates and maintains reports and portals to post, track, and report on initiatives, policies and procedures within contracts.
• Assists in implementation of new third party plans and updates to ongoing plans; reviews admin paperwork and routes information to internal departments.
• Reviews contracts and provides feedback to management regarding potential opportunities and compliance issues.
• Escalates issues as necessary.
• Assists in development of financial models to support management decision-making related to new product development, profitability, capital investments, and regulatory impacts.
• Performs ad hoc analysis and forecasts for internal management and external customers.
• Develops and maintains SOPs and provides guidance on processes related to Contracts & Pricing.
• Develops client relationships and reports gaps in client service and business issues to management.
• Assists field personnel and management in resolving member issues.

Skills

Data analysis

Time management

Customer service

Project management

Lean methodologies

Education

Bachelor's degree OR High School Diploma / GED and at least 3 years of experience in healthcare industry

Tools

Microsoft Excel

Microsoft PowerPoint

Microsoft Word

AS400

SIMS

POS

IC+

Job description

Job Summary

Analyzes data to support the decision making on individual proposals and contracts related to pharmacy programs. Data analysis may include new product pricing, product portfolio, profitability of new opportunities with current and new clients, impacts of regulatory changes, capital analysis, and profit margin analysis. Assists in the development, implementation, on-going monitoring of strategies and tools to ensure 3rd party pharmacy programs are in compliance with contractual terms and conditions pertaining to designated product or service offering.

Job Responsibilities

• Creates and maintains reports and portals to post, track, and report on initiatives, policies and procedures, departmental forms, and contracted policies and information within contracts.
• Assists in the implementation processes of new third party plans and updates to ongoing third party plans; reviews and approves administrative paperwork prior to routing implementation information to the appropriate internal departments. Assists with tracking and resolving post-implementation issues related to contracts and pricing.
• Reviews contracts and provides feedback to management regarding potential opportunities, immediate needs related to contracted terms and programs, resolves contract compliance issues and tracks financial impact.
• Escalates issues as necessary.
• Assists in development of financial models to support management decision-making related to new product development, product portfolio analysis, profitability of new opportunities, capital investments, revenue models, profit margin analysis, and impact of regulatory changes. Presents findings to managements and makes recommendations that are market competitive and fit with Walgreens' strategy.
• Performs ad hoc analysis and forecasts for internal management team and external customers.
• Assist in the development of SOPs and provides guidance on processes, procedures, and functionality related to Contracts & Pricing.
• Develops and maintains client relationships by providing services required to meet client needs while monitoring operational policies and procedures; reports gaps in client service and business issues of non-compliance to management.
• Assists field personnel and management in resolving member issues

About Walgreens

Founded in 1901, Walgreens (www.walgreens.com) proudly serves nearly 9 million customers and patients each day across its approximately 8,500 stores throughout the U.S. and Puerto Rico. Walgreens has approximately 220,000 team members, including nearly 90,000 healthcare service providers, and is committed to being the first choice for pharmacy, retail and health services, building trusted relationships that create healthier futures for customers, patients, team members and communities.

Basic Qualifications

• Bachelor's degree OR High School Diploma / GED and at least 3 years of experience in healthcare industry.
• Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
• Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates.
• Experience providing customer service to internal and external customers, including meeting quality standards for services.
• Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
• Intermediate level skill in Microsoft PowerPoint (for example: applying a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font).
• Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
• Understanding of project management and lean methodologies.
• Willing to travel up to 10% of the time for business purposes (within state and out of state).

Preferred Qualifications

• Advanced level skill in Microsoft Excel (for example: using AVERAGE function, merging and centering cells, printing centered page and/or creating a pivot table).
• At least 2 years experience implementing contracted Third Party programs in the healthcare industry.
• At least 2 years’ experience administering healthcare contracts.
• At least 2 years Payor and facility credentialing experience.
• At least 2 years medical reimbursement/fee schedule maintenance experience.
• Infusion, Specialty Pharmacy, Retail Clinic, and/or Pharmacy Technician experience.
• Experience using Walgreen proprietary systems (e.g. AS400, SIMS, POS, IC+)
• At least 2 years experience working in retail pharmacy operations.
• Experience providing customer service to internal and external customers, including meeting quality standards and evaluation of customer satisfaction.

We will consider employment of qualified applicants with arrest and conviction records.

The Salary below is being provided to promote pay transparency and equal employment opportunities at Walgreens. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience and other relevant factors. This role will remain open until filled.

Salary Range: $65000 - $113750 / Salaried