Pharmacy Analyst (Medicaid Business Unit - Remote)

Lensa; Columbus (OH); Remote; USD 57,000 - 108,000; Full time

Job summary

A leading healthcare company is seeking a Pharmacy Analyst for their Medicaid Business Unit. This remote position involves managing projects, analyzing data, and ensuring compliance with regulations. Candidates should possess strong communication skills and healthcare experience. The role offers a competitive salary range based on qualifications and experience.

Qualifications

• Required healthcare and project management experience.
• Preferred project management experience.

Responsibilities

• Manage projects, analyze data for process improvements.
• Ensure compliance with regulations and develop solutions.
• Communicate effectively across organizational levels.

Skills

Advanced MS Office

Critical Thinking

Trend Analysis

Problem Assessment

Excellent Communication

Education

High school diploma / GED

Bachelor's Degree

Job description

Pharmacy Analyst (Medicaid Business Unit - Remote)

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Company:

Highmark Inc.

Job Description:

JOB SUMMARY
Work with the Pharmacy Medicaid/DSNP Business Unit Business Owners, Stakeholders, and Management to achieve growth objectives. Organize and coordinate activities, monitor progress, and perform corrective actions to ensure timely and relevant results. Communicate regularly with customers regarding issues or concerns. Responsibilities include:

• Manage projects, analyze data for process improvements, and lead initiatives of various sizes.
• Research and develop new Pharmacy Medicaid/DSNP services or programs, evaluating feasibility and implementation.
• Ensure compliance with regulations, policies, and guidelines, monitoring legislative and industry trends.
• Provide advanced analytics, develop predictive models, and collaborate with stakeholders to translate insights into strategies.
• Translate business needs into detailed requirements, functional designs, and system specifications for applications and change requests.

ESSENTIAL RESPONSIBILITIES

• Implement product designs, ensure quality and regulatory standards, develop standardized processes, and measure performance. Collaborate with business owners to identify and improve areas needing attention.
• Analyze data and business processes, support program oversight, and develop solutions for problems.
• Work with multidisciplinary teams to ensure program effectiveness, manage projects, and resolve escalated issues.
• Develop business and pharmacy benefit solutions, conduct problem-solving sessions, and promote continuous improvement.
• Communicate effectively across organizational levels, articulate problems, and facilitate strategic planning.
• Research competitive pharmacy benefits, ensuring market positioning and member satisfaction.
• Perform other duties as assigned.

Education:

• Required: High school diploma / GED
• Preferred: Bachelor's Degree

Experience:

• Required: Healthcare experience, Project Management experience
• Preferred: Project Management

Skills:

• Advanced MS Office skills, experience in presentations, critical thinking, trend analysis, problem assessment, excellent communication.

Additional Details:

Travel: 0-25%; Position: Office-based; Physical demands include lifting up to 25 pounds occasionally. Complies with legal, ethical, and privacy standards, including HIPAA.

Compensation:

Range: $57,700 - $107,800. Pay depends on qualifications, experience, and location.