Medicare Pharmacy Analytics & Formulary Lead

Provider Partners; United States; On-site; USD 70,000 - 90,000; Full time

Job summary

Provider Partners is looking for a Pharmacy Business Analyst for their Medicare Advantage Plan. This role involves analyzing pharmacy data to support the development of pharmacy benefit strategies and ensuring compliance with regulations.

The ideal candidate will have a Bachelor’s degree in a related field and a minimum of 3 years of experience in pharmacy benefits management. Strong analytical and communication skills are essential.

Qualifications

• Minimum of 3 years of experience in pharmacy benefits management, healthcare analytics, or a related field.
• Experience working with Medicare Advantage plans is highly desirable.

Responsibilities

• Analyze pharmacy utilization patterns and claims data to identify opportunities for cost savings.
• Assist in the evaluation and optimization of the drug formulary.
• Ensure adherence to CMS regulations related to pharmacy benefits.
• Identify and analyze high-cost medications for managing pharmacy spend.
• Collaborate with cross-functional teams to improve communication of pharmacy benefits.
• Lead pharmacy-related projects to enhance operational efficiency.

Skills

Strong analytical skills

Communication skills

Detail-oriented

Organizational abilities

Education

Bachelor’s degree in Pharmacy or related field

PharmD preferred

Tools

Excel

SQL

Business intelligence software

Job description

Provider Partners is looking for a Pharmacy Business Analyst for their Medicare Advantage Plan. This role involves analyzing pharmacy data to support the development of pharmacy benefit strategies and ensuring compliance with regulations.

The ideal candidate will have a Bachelor’s degree in a related field and a minimum of 3 years of experience in pharmacy benefits management. Strong analytical and communication skills are essential.