Senior Pharmacy Compliance & Analytics Lead

Healthfirst; New Jersey; On-site; USD 138,000 - 155,000; Full time

Benefits offered by this job

Health insurance

Dental coverage

Vision coverage

401(k) plan

Life insurance

Incentive programs

Job summary

Healthfirst in the New York metropolitan area is seeking a Senior Pharmacy Compliance Reporting Analyst to strengthen regulatory reporting and MTM program insights. You will analyze data, develop analytics, and automate compliance processes for PBM and delegated vendors.

Ideal candidates have 5+ years in data management for managed care or pharmacy benefits, with strong BI skills and regulatory reporting experience. This is a full-time role with competitive pay and benefits.

Qualifications

• 5 years of experience gathering, analyzing and communicating complex analytical requirements to diverse audiences.
• 5 years of experience developing dashboards and reports to measure performance of products.
• 5 years of experience using BI/reporting tools including Base SAS, SAS EG, Tableau, Aginity Workbench, SQL Server and Management Studio.
• 5 years of experience managing multiple concurrent projects across Finance, Benefits, Utilization Management, Regulatory and Compliance, and Specialty Pharmacy.
• 5 years of experience writing scalable, well-documented code to support system enhancements.

Responsibilities

• Promote regulatory compliance by analyzing, identifying, and addressing risks to regulatory requirements.
• Collaborate with other departments to drive implementation, execution and monitoring of regulatory 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 identifications and support MTM reporting to drive outreach success.
• Ensure data integrity and develop analytics tools for day-to-day operations.
• Enhance and automate compliance reporting, data collection, governance and reporting.
• Develop analytics for risk detection, profiling and mitigation.
• Coordinate MTM enrollment targeting monthly.
• Assist with MTM outreach data requests and monitoring approvals/rejections.
• Oversee communications related to regulatory expectations including OIG/OMIG lists and Transparency in Coverage.
• Participate in internal and external audits and deliver ad-hoc reporting.

Skills

Data analysis

Stakeholder communication

Regulatory compliance

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 in the New York metropolitan area is seeking a Senior Pharmacy Compliance Reporting Analyst to strengthen regulatory reporting and MTM program insights. You will analyze data, develop analytics, and automate compliance processes for PBM and delegated vendors.

Ideal candidates have 5+ years in data management for managed care or pharmacy benefits, with strong BI skills and regulatory reporting experience. This is a full-time role with competitive pay and benefits.