Pharmacy Revenue & Optimization Analyst

AndHealth; Columbus (OH); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid time off

Short- and Long-Term Disability

Job summary

AndHealth is seeking a Pharmacy Program Optimization Analyst in Columbus, OH, to maximize the efficiency of federal drug pricing programs. The role focuses on optimizing claim capture, data analysis, and collaboration with FQHCs,TPAs, and pharmacy operations to improve paid claim rates.

Responsibilities include monitoring claims, analyzing data to confirm eligibility, troubleshooting eligibility issues, and developing policies to drive program performance and revenue capture across multiple

Qualifications

• Bachelor’s degree in a quantitative field or equivalent practical experience.
• Proven experience with federal drug pricing program operations and paid claims workflow.
• Excel mastery and analytics tool proficiency.
• Ability to use EHR and pharmacy operating systems.
• Strong problem-solving, organization, and communication skills.
• Nice to have SQL experience.

Responsibilities

• Monitor pharmacy claims across partners to identify trends and opportunities to improve claim capture.
• Analyze data from EHRs, TPAs, and pharmacy systems to verify program eligibility and utilization.
• Troubleshoot live issues impacting program eligibility or optimization.
• Develop and maintain program policies, procedures, and reporting to support optimization and transparency.
• Generate reports for audits, leadership visibility, and budget forecasting.
• Engage with partners to optimize reimbursement workflows and compliance.

Skills

Excel

Problem-solving

Data analysis

Communication

Attention to detail

SQL

Education

Bachelor’s degree in Computer Science, Economics, Engineering, Mathematics, or related quantitative field

Tools

EHR systems

Pharmacy operating systems

Job description

AndHealth is seeking a Pharmacy Program Optimization Analyst in Columbus, OH, to maximize the efficiency of federal drug pricing programs. The role focuses on optimizing claim capture, data analysis, and collaboration with FQHCs,TPAs, and pharmacy operations to improve paid claim rates.

Responsibilities include monitoring claims, analyzing data to confirm eligibility, troubleshooting eligibility issues, and developing policies to drive program performance and revenue capture across multiple