Pharmacy Analyst (Medicaid Business Unit - Remote)

Lensa; Concord (NH); Remote; USD 57,000 - 108,000; Full time

Job summary

An established industry player is seeking a Pharmacy Analyst to join their Medicaid Business Unit. This remote position involves collaborating with stakeholders to achieve growth objectives, managing projects, and ensuring compliance with regulations. You will play a critical role in developing new services and enhancing existing programs while utilizing advanced analytics to drive strategic decisions. If you are passionate about improving healthcare services and have a knack for problem-solving, this opportunity could be the perfect fit for you.

Qualifications

• Healthcare and project management experience required.
• Strong analytical and problem-solving skills essential.

Responsibilities

• Manage projects, analyze data for trends and improvements.
• Ensure compliance with regulations and monitor changes.
• Develop solutions to meet goals and promote quality improvement.

Skills

Advanced MS Office skills

Presentation skills

Critical thinking

Problem identification and assessment

Verbal and written 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's Business Owners, Stakeholders, and Management to achieve growth objectives. Organize and coordinate activities to ensure successful delivery of results. Monitor progress, evaluate status, and perform corrective actions as needed. Communicate regularly with customers regarding issues or concerns. Responsibilities include:

• Manage projects of various sizes, analyze data for trends, problems, or process improvements.
• Research and develop new Pharmacy Medicaid/DSNP services or programs, evaluate feasibility, and oversee implementation.
• Ensure compliance with regulations, policies, and contractual guidelines; monitor legislative and industry changes.
• Provide advanced analytics support, develop predictive models, and collaborate to translate insights into strategies.
• Understand business needs, develop requirements, designs, and specifications for applications and changes.

Essential Responsibilities

• Implement product and program designs, ensure quality, financial, and regulatory standards are met. Develop standardized processes and measurement methods. Collaborate to identify improvement areas and develop action plans.
• Analyze data and business processes, support program oversight, and test solutions. Make decisions to improve practices or develop new approaches.
• Work with multidisciplinary teams across departments and vendors to ensure program effectiveness. Manage small to medium projects as applicable.
• Resolve escalated or complex issues.
• Develop solutions to meet goals, conduct problem-solving sessions, and promote performance and quality improvement.
• Communicate effectively across organizational levels, share information, and articulate problems to management and sponsors.
• Research and develop competitive pharmacy benefit offerings, focusing on member experience and product viability.
• Other duties as assigned.

Education

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

Experience

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

Certifications

• Required: None
• Preferred: Six-Sigma

Skills

• Advanced MS Office skills.
• Experience in presentations to diverse audiences.
• Strong critical thinking and pattern recognition skills.
• Ability to identify problems, assess options, and recommend actions.
• Excellent verbal and written communication skills.

Additional Details

Travel: 0%-25%

Position: Office-based, teaches/trains regularly, occasional travel, physical demands include lifting up to 25 pounds, etc.

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

Compliance: Adheres to legal, ethical, and privacy standards, including HIPAA and company policies.