Pharmacy Analyst (Medicaid Business Unit - Remote)

Lensa; Salt Lake City (UT); Remote; USD 57,000 - 108,000; Full time

Job summary

An innovative healthcare organization is looking for a Pharmacy Analyst to drive growth in the Medicaid Business Unit. This remote position involves managing projects, analyzing data, and collaborating with stakeholders to develop new pharmacy services. The ideal candidate will possess strong analytical skills and a background in healthcare, ensuring compliance with regulations while enhancing member experience. Join a dynamic team that values continuous improvement and effective communication, where your contributions will directly impact the organization's success and member satisfaction.

Qualifications

• Healthcare and project management experience required.
• Project management certification preferred.

Responsibilities

• Manage projects and analyze data for process improvements.
• Develop new pharmacy Medicaid/DSNP services through research.
• Ensure compliance with regulations and industry trends.

Skills

MS Office

Critical Thinking

Trend Analysis

Problem-Solving

Excellent Communication

Education

High School Diploma/GED

Bachelor's Degree

Job description

Pharmacy Analyst (Medicaid Business Unit - Remote)

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Lensa is the leading career site for job seekers at every stage of their career. Our client, Highmark Health, is seeking professionals. Apply via Lensa today!

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 to focus on delivering desired results. Monitor progress and perform corrective actions as needed. Communicate regularly with customers regarding issues or concerns. Responsibilities include:

• Manage projects, analyze data for process improvements, and lead initiatives to meet business objectives.
• Develop new pharmacy Medicaid/DSNP services or programs through research and feasibility analysis.
• Ensure compliance with regulations, policies, and industry trends.
• Provide advanced analytics, predictive modeling, and stakeholder collaboration to develop business strategies.
• Translate business needs into requirements and system specifications for applications and enhancements.

Essential Responsibilities

• Implement product and program designs, ensuring quality, financial, and regulatory standards are met. Develop standardized processes and measurement methods. Identify areas for improvement and develop action plans. Understand KPIs and metrics.
• Analyze data and business processes to support program oversight, audits, and problem-solving. Make decisions to refine practices and develop new approaches.
• Collaborate with multidisciplinary teams within Highmark and external vendors to ensure project effectiveness. Manage small to medium projects and escalate complex issues.
• Develop solutions to satisfy goals, conduct problem-solving sessions, and promote continuous improvement.
• Communicate effectively across organizational levels, identifying and articulating problems and solutions.
• Research competitive pharmacy benefits and ensure market positioning, focusing on member experience and product viability.
• Perform other duties as assigned.

Qualifications

Education: High school diploma/GED required; Bachelor's degree preferred.

Experience: Healthcare and project management experience required; project management certification preferred.

Skills: Proficiency in MS Office, presentation skills, critical thinking, trend analysis, problem-solving, and excellent communication skills.

Additional Information

Travel: 0-25%

Position: Office-based, with occasional travel and physical demands as specified.

Salary Range: $57,700 - $107,800, based on qualifications and experience.

Compliance: Adheres to ethical standards, confidentiality, HIPAA, and company policies.