Pharmacy Analyst (Medicaid Business Unit - Remote)

Highmark Health; United States; Remote; USD 57,000 - 108,000; Full time

Job summary

An established industry player seeks a dynamic individual to join their Pharmacy Medicaid/DSNP business unit. In this role, you will drive growth objectives by effectively managing projects, ensuring compliance, and providing analytical support. Collaborating with multidisciplinary teams, you will implement innovative solutions and enhance member experiences. This position offers an opportunity to engage with stakeholders at all levels, making a tangible impact on the organization’s success. If you're passionate about healthcare and thrive in a collaborative environment, this is the perfect opportunity for you.

Qualifications

• Healthcare experience and project management experience required.
• Bachelor's degree preferred for advanced roles.

Responsibilities

• Manage projects and ensure compliance with quality and regulatory standards.
• Analyze data and business processes to support program oversight.

Skills

MS Office

presentation skills

critical thinking

problem assessment

communication skills

Education

High school diploma / GED

Bachelor's Degree

Job description

Company : Highmark Inc.

Job Description :

JOB SUMMARY

Work with the Pharmacy Medicaid/DSNP business unit to achieve growth objectives by organizing activities, monitoring progress, and communicating effectively with stakeholders. Responsibilities include managing projects, researching new services, ensuring compliance, providing analytic support, and translating business needs into system requirements.

ESSENTIAL RESPONSIBILITIES

• Implement product and program designs, ensuring quality, financial, and regulatory standards are met. Develop standardized processes and continuous improvement methods. Collaborate with business owners to identify improvement areas and develop action plans.
• Analyze data and business processes to support program oversight, using measurement and audit techniques. Design and test solutions, and make decisions to improve practices.
• Work with multidisciplinary teams to ensure program effectiveness and manage projects. Handle escalated issues and develop business solutions aligned with goals.
• Communicate with all organizational levels, articulate problems, and facilitate strategic planning and implementation.
• Research competitive pharmacy benefits to optimize member experience and market positioning.
• 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

• Proficient in MS Office, presentation skills, critical thinking, problem assessment, communication skills.

Other Details

Travel: 0-25%

Position: Office-based, includes training, occasional travel, physical demands as specified.

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

Compensation

Range: $57,700 - $107,800, based on qualifications and market factors.

Highmark is committed to diversity and accessibility. For accommodations, contact [e-mail].