Pharmacy Claims Optimization & Analytics Analyst

AndHealth LLC; Columbus (OH); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid time off

Disability insurance

Job summary

AndHealth LLC in Columbus, OH is seeking a Pharmacy Program Optimization Analyst to maximize efficiency of partner federal drug pricing programs and enhance revenue capture across pharmacy initiatives. You will monitor claims data from EHRs and pharmacy systems, analyze trends, troubleshoot live issues, and partner with providers to align billing configurations and optimize program outcomes.

This role requires strong analytical skills, attention to detail, and the ability to translate data into

Qualifications

• Bachelor's degree or equivalent practical experience preferred.
• Experience with federal drug pricing program operations and paid claims workflows.
• Strong Excel skills and ability to analyze data for reporting.

Responsibilities

• Proactively monitor Pharmacy claims across partners to identify trends and opportunities to improve claim capture.
• Investigate missing claim data and address root causes with FQHCs, TPAs, and pharmacy operations.
• Analyze data from EHRs, TPAs and pharmacy systems to track program eligibility and utilization.
• Troubleshoot live issues affecting eligibility or optimization of programs.
• Maintain relationships with providers and partners to support workflows and drive efficiency.
• Create and update program policies emphasizing optimization and savings tracking.

Skills

Federal drug pricing operations

Excel

Data analysis

Problem solving

EHR systems

Attention to detail

Education

Bachelor's degree or equivalent practical experience

Tools

SQL

Job description

AndHealth LLC in Columbus, OH is seeking a Pharmacy Program Optimization Analyst to maximize efficiency of partner federal drug pricing programs and enhance revenue capture across pharmacy initiatives. You will monitor claims data from EHRs and pharmacy systems, analyze trends, troubleshoot live issues, and partner with providers to align billing configurations and optimize program outcomes.

This role requires strong analytical skills, attention to detail, and the ability to translate data into