Senior Pharmacy Compliance Analytics Lead

Healthfirst; Georgia; Hybrid; USD 138,000 - 155,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

401(k) contributions

Competitive compensation

Job summary

Healthfirst, a not-for-profit health insurer serving New York, seeks a Senior Pharmacy Compliance Reporting Analyst to strengthen regulatory compliance and analytics in Pharmacy Operations. The role emphasizes data integrity, MTM program reporting, and collaboration with PBMs to ensure adherence to federal and state requirements.

Responsibilities include developing analytics tools, risk detection, and reporting enhancements to support MTM outreach and regulatory governance across multiple teams.

Qualifications

• Bachelor’s degree in computer science, information science, electrical engineering, or related field and 5 years of experience in data management and analytics for managed care ops or as a PBM.
• 5 years of experience gathering, analyzing and communicating complex analytical business requirements to diverse audiences.
• 5 years of experience developing and utilizing reports and dashboards to analyze and measure performance of products.

Responsibilities

• Promote compliance by analyzing, identifying, and addressing risks to regulatory requirements.
• Collaborate with other departments to drive implementation, execution and monitoring of regulatory/compliance strategies for Pharmacy Operations.
• Support the Director of Pharmacy Operations to ensure PBM and other vendors adhere to federal and state regulations.
• Run monthly MTM member identification and support MTM regulatory components and reporting.

Skills

Data management

Analytics

Regulatory compliance

BI dashboards

SAS

SQL

Project management

Software development

Education

Bachelor’s degree in CS/IS/EE or related field

Tools

Base SAS

SAS EG

Tableau

Aginity Workbench

SQL Server

Management Studio

Job description

Healthfirst, a not-for-profit health insurer serving New York, seeks a Senior Pharmacy Compliance Reporting Analyst to strengthen regulatory compliance and analytics in Pharmacy Operations. The role emphasizes data integrity, MTM program reporting, and collaboration with PBMs to ensure adherence to federal and state requirements.

Responsibilities include developing analytics tools, risk detection, and reporting enhancements to support MTM outreach and regulatory governance across multiple teams.