Senior Pharmacy Compliance Analytics Lead

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

Benefits offered by this job

Medical, dental and vision coverage

Life insurance

401k contributions

Job summary

Healthfirst is seeking a Senior Pharmacy Compliance Reporting Analyst to promote regulatory compliance and drive operational insights across Pharmacy Operations. The role focuses on risk analysis, MTM program reporting, and data-driven improvements.

The candidate will collaborate with multiple departments, ensure PBM/vendor adherence to regulations, and develop automated reporting solutions to support audits and transparency requirements.

Qualifications

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

Responsibilities

• Promote compliance by analyzing and addressing regulatory risks for Pharmacy Operations.
• Collaborate with departments to implement and monitor regulatory/compliance strategies.
• Ensure PBM and vendors adhere to federal and state regulations.
• Run MTM member identifications, support MTM regulatory components and reporting.
• Develop data integrity, insights, and analytic tools for day-to-day operations.
• Enhance and automate compliance reporting including data collection, governance, and reporting.
• Develop analytics for risk detection, profiling, and issue mitigation.
• Target MTM enrollment monthly and support MTM outreach evaluations.
• Oversee language and timeliness of enrollee/provider/pharmacy communications per regulatory expectations.
• Represent department in compliance with Transparency in Coverage Rule and participate in audits.
• Deliver ad-hoc reports identifying compliance and operational inefficiencies.

Skills

Analytical requirements gathering

Reporting/dashboard development

BI/Reporting tools proficiency

Multi-project management

Coding for maintainable systems

Tools

Base SAS

SAS EG

Tableau

Aginity Workbench

SQL Server

Management Studio

Job description

Healthfirst is seeking a Senior Pharmacy Compliance Reporting Analyst to promote regulatory compliance and drive operational insights across Pharmacy Operations. The role focuses on risk analysis, MTM program reporting, and data-driven improvements.

The candidate will collaborate with multiple departments, ensure PBM/vendor adherence to regulations, and develop automated reporting solutions to support audits and transparency requirements.