Remote Pharmacy Network Analytics & Ops Specialist

Pharmacy Data Management, Inc.

Poland Township (OH)

Remote

USD 70,000 - 95,000

Full time

14 days+

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Benefits offered by this job

Fully remote

Job summary

Pharmacy Data Management, Inc. (PDMI) is seeking a Pharmacy Network Operations Analyst to support analysis, maintenance, and optimization of pharmacy networks, MAC pricing, and reimbursement methodologies. This role drives data-driven decisions and system updates across client networks.

The ideal candidate has a Bachelor's degree and 3+ years in pharmacy network analytics, with strong SQL/TOAD data skills. PDMI offers a fully remote role with opportunities to influence pricing strategies and

Qualifications

Bachelor's degree or equivalent industry experience.
3+ years of pharmacy network experience preferred.
Experience with SQL/TOAD or similar reporting tools.

Responsibilities

Acquire and maintain understanding of pharmacy network structure, rates, MAC pricing, provider demographics, and related operational components.
Maintain and update pharmacy network design, demographic data, MAC operations, reimbursement methodologies, and network-related system updates.
Provide guidance on pricing strategies and implementation for pharmacy reimbursement.
Research and analyze claims, MAC issues, and pricing/reimbursement discrepancies.
Develop and maintain operational audit tools and support audit activities across the network.
Create analytical and operational reports related to network performance, MAC activity, audits, and client requests.
Lead or support ad-hoc analysis and reporting for internal stakeholders' network decisions.
Establish and update procedures for accurate claims adjudication and network maintenance.
Participate in policy and procedure development for Pharmacy Network operations and continuous improvement initiatives.
Build collaborative relationships with internal departments to implement network contracts and pricing updates.