Remote Pharmacy Network Operations Analyst

Pharmacy Data Management, Inc.; Northern (KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Fully remote work

Collaborative environment

Job summary

PDMI is seeking a Pharmacy Network Operations Analyst to analyze, maintain, and optimize our pharmacy and client networks. You will work on network design, MAC pricing, and issue resolution through detailed data analysis and system updates.

Ideal candidates have a health administration or analytics background with 3+ years in pharmacy networks, and comfort with SQL/TOAD for reporting. This is a fully remote role in the US with cross-functional collaboration.

Qualifications

• Bachelor's degree or equivalent industry experience required.
• 3+ years of pharmacy network experience preferred.
• Database development and reporting using SQL, TOAD, or similar tools.

Responsibilities

• Acquire and maintain understanding of pharmacy network structure, rates, MAC pricing, and provider demographics.
• Maintain and update network design, pharmacist demographics, MAC operations, and reimbursement methods.
• Provide guidance on pricing strategies and implementation considerations for reimbursement.
• Research and analyze claims, MAC issues, and pricing or reimbursement discrepancies.
• Develop and maintain operational audit tools and support audit activities.
• Create analytical reports on network performance, MAC activity, and client requests.
• Lead or support ad-hoc analyses to assist internal stakeholders in decision making.
• Assist with procedures for accurate claims adjudication and network maintenance.
• Contribute to policy and procedure development for Pharmacy Network operations and continuous improvement.
• Collaborate with internal departments to ensure correct implementation of contracts and pricing updates.

Skills

SQL

Data analysis

Pharmacy network

Pricing strategies

MAC operations

Stakeholder communication

Education

Bachelor's in Health Administration/Healthcare Analytics/Business/Finance

Tools

TOAD

SQL tools

Job description

PDMI is seeking a Pharmacy Network Operations Analyst to analyze, maintain, and optimize our pharmacy and client networks. You will work on network design, MAC pricing, and issue resolution through detailed data analysis and system updates.

Ideal candidates have a health administration or analytics background with 3+ years in pharmacy networks, and comfort with SQL/TOAD for reporting. This is a fully remote role in the US with cross-functional collaboration.