Senior PBM Pricing Analyst

Shelby American, Inc.; Dubuque (IA); Hybrid; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Strategic Pricing Analyst to optimize financial outcomes through data analysis and pricing models. This exciting role involves monitoring contract performance, analyzing pharmacy claims data, and collaborating across departments to deliver actionable insights. Join a vibrant team that prioritizes well-being and offers competitive benefits, including comprehensive health insurance and opportunities for professional growth. If you're passionate about making a difference and thrive in a collaborative environment, this position is perfect for you!

Benefits

Competitive salary and bonuses

Comprehensive health, dental, and vision insurance

401(k) with company match

Generous paid time off

Opportunities for professional growth

Collaborative work culture

Qualifications

• 2+ years of experience in PBM or pharmacy pricing role.
• Advanced knowledge of reporting and data analysis tools.

Responsibilities

• Monitor client and pharmacy contracts and financial performance.
• Develop pricing models and execute financial reconciliations.
• Collaborate with teams to provide actionable insights.

Skills

Data Analysis

Financial Modeling

SQL

Excel

Problem Solving

Time Management

Strategic Thinking

Education

Bachelor’s Degree in Math, Computer Science, Engineering, IT, Statistics, Economics, or Finance

Tools

SSRS

BI Tools

Ad hoc Query Tools

Job description

Description

Position Overview: The Strategic Pricing Analyst position monitors contract performance, analyzes pharmacy claims data, delivers financial reconciliations, and develops pricing models to optimize financial outcomes while collaborating across departments to provide actionable insights and solutions.
About MedOne: MedOne is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully transparent, pass-through model, MedOne helps people conveniently access the most appropriate prescriptions at the most affordable price.
What You'll Do:

1. Review and monitor client and pharmacy contracts and our financial performance against them on an ongoing basis
2. Prepare, investigate, and deliver client financial guarantee reconciliations
3. Investigate changes or unexpected trends client or pharmacy performance by analyzing pharmacy claims data and looking for outliers or trends over time
4. Collaborate with team members to execute MAC appeals process on a weekly basis
5. Develop and execute recurring reports/research processes for discount card line-of-business
6. As needed, use and design pricing models and analysis templates e.g., to hit financial targets, predict the impact of pricing/utilization changes, and/or determine the size of risks/opportunities
7. Execute MAC maintenance tasks, audit processes, and uploads; as needed during execution, identify discrepancies, assess risk, and recommend solutions
8. Expand and update share the Pricing team’s SQL data environment by adding new and relevant data sources based on evolving business needs
9. Conduct ad hoc inquiries and analyses in a timely manner by synthesizing disparate data sources to provide clear and actionable information to both internal and external stakeholders
10. Continuously engage in process analysis and problem solving to identify opportunities that can be addressed via automation tools and/or applications
11. Lead interdepartmental collaborations as needed and develop positive relationships with other teams/business units
12. Assist, train, and review the work product of peers within the Strategic Pricing business unit
13. Plan and execute short-term and medium-term Pricing projects
14. Portray the company in a positive image
15. Abide by all rules, regulations, and policies of the employee
16. Other duties as assigned

What You Will Bring to MedOne:

1. Bachelor’s Degree in Math, Computer Science, Engineering, IT, Statistics, Economics, or Finance, or equivalent experience. Must be eligible to work in the United States without need for work visa or residency sponsorship. Should be under no restrictive non-compete covenant from a previous or existing employer.
2. 2+ years of work experience in PBM or pharmacy pricing role
3. Data mining and/or financial modeling using industry standard tools in similar roles
4. Ability to translate business requirements to accurate technical specifications, with the end goal of creating optimized business reports that can be easily applied to meet the business use case.
5. Advanced knowledge of reporting, data analysis, and problem solving using analytical tools such as advanced Excel, SQL, SSRS, BI tools and/or ad hoc Query Tools.
6. Ability to create and successfully implement programs for automation.
7. Relevant experience that demonstrates problem-solving, financial acumen, and ability to understand, analyze and decrypt complex processes.
8. Ability to think strategically and proactively.
9. Time management and prioritization skills.
10. Incredible work ethic and energy.

Why MedOne?

At MedOne, we believe that a healthy team is a happy team. We offer a collaborative work environment, competitive benefits, and opportunities for growth—all while helping to make a difference in people’s lives. Our top core value is to prioritize your well-being. To support you in living this value, we offer:

1. Competitive salary and bonuses that reward your performance.
2. Comprehensive health, dental, and vision insurance + additional benefits
3. 401(k) with company match to secure your future.
4. Generous paid time off and holidays.
5. Opportunities for professional growth and development.
6. A vibrant and collaborative work culture.

Location: Offices in either Dubuque, IA, or Kansas City, MO, or the position can be remote within the United States.

Employment Type: Full Time, Salary

Reports to: Senior Director of Strategic Pricing

How to Apply: If you're enthusiastic about helping others and eager to join a dynamic team, we’d love to hear from you. Apply now and take the first step toward a rewarding career at MedOne! You can submit your application through our careers page.

MedOne is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Offers are contingent on passing a background check and drug screen.