Network Pricing Specialist

Insight Global; United States; On-site; USD 28,929 - 34,440; Part time

Job summary

A leading staffing firm is looking for a Network Pricing Data Analyst. The role involves analyzing benefit requirements and supporting new product development in a pharmaceutical context. Candidates should have a minimum of a Bachelor's degree, two years of related experience, and strong communication skills. This is a contract position with an associate seniority level offering a competitive pay range.

Qualifications

• Bachelor's degree in IT, Business, Mathematics, or equivalent required.
• 2 years of experience in network operations or healthcare operations.
• Ability to analyze information to resolve complex issues.

Responsibilities

• Participate in client-facing projects and implementation interactions.
• Review and execute escalated network operations requests.
• Guide complex projects and assist on others.

Skills

Strong communication and collaboration skills

Querying skills

Education

Bachelor's degree in IT, Business, Mathematics or related area

Tools

Microsoft Word

Microsoft Excel

AS400 system

Alteryx

SQL

Job description

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$21.00/hr - $25.00/hr

Direct message the job poster from Insight Global

Insight Global is seeking a Network Pricing Data Analyst to join one of our large PBM clients. This individual will be responsible for research and interpretation of benefit requirements necessary to support new and existing benefits and product development. This position performs analysis related to proper network, pricing design and system requirements necessary for accurate claims processing, which includes maintenance of documents, process improvements, feasibility testing and quality audit.

Required Skills & Experience

• Bachelors degree in IT, Business, Mathematics or related area of study, or equivalent combination of education and relevant work experience; HS diploma or GED required
• 2 years of work experience in network operations, pharmacy benefit management operations or and/or healthcare operations inclusive of experience manipulating large, complex data sets.
• Strong communication and collaboration skills
• Querying skills

Additional Qualifications

• Effectively analyze information to resolve complex issues
• Experience working on client facing initiatives, projects, and issue resolution
• Organizational skills with ability to work on multiple projects simultaneously under strict timelines
• Ability to drive results with strong commitment toward continuous process improvement and customer service.
• Proficient in Microsoft Word and Excel.
• Knowledge of AS400 system, query tools and advanced Excel functions

Nice to Have Skills & Experience

• Work experience in pharmacy benefit design, claims processing, or Pharmacy Benefit Management (PBM)

Responsibilities

• Represent Network Operations and participate in large scale client facing projects, internal cross functional projects, and implementation interactions by providing insight, recommendations, and requirement gathering for Network Operations related items
• Review and execute escalated, new, revised, and non-standard network operations requests; determine RxClaim system set up to ensure claims sequencing is accurate based upon analysis and interpretation for Commercial, Medicare Part D, and Specialty Pharmacy programs
• Represent Network Operations by effectively communicating procedures, quality controls and addressing other related inquiries during internal and external audits
• Guide multiple smaller but complex projects independently and/or assist Functional Business Consultant on complex projects. Projects will include large sets of data and analysis with tools such as Alteryx, AQT and SQL
• Perform complex quality reviews of large sets of data and analysis of cases to prevent errors based on strict compliance, service level agreements, and regulatory guidance
• Assist in the intake of new projects, business initiatives and process improvements; work directly with assigned business area and consult with various levels across organizations as needed.
• Create and deliver informal training for project and process improvements for successful and timely completion of work.
• Perform user acceptance testing at a feature level and present new features to users in individual or group settings

Seniority level

• Associate

Employment type

• Contract

Job function

• Administrative, Information Technology, and Accounting/Auditing

Industries

• Pharmaceutical Manufacturing

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