[Remote] Pharmacy Business Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Pharmacy Business Analyst for their Medicare Advantage Plan. This role involves analyzing pharmacy data, developing pharmacy benefit strategies, and collaborating with cross-functional teams to enhance operational efficiency and ensure compliance with regulations.
Responsibilities
- Analyze pharmacy utilization patterns, claims data, and cost trends to identify opportunities for cost savings and improved patient reputed company
- reputed company and maintain reporting tools, dashboards, and performance metrics to reputed company key pharmacy business indicators
- Assist in the evaluation and optimization of the drug formulary to ensure cost-effective medication reputed company are available to members
- Monitor drug utilization and reputed company therapeutic class reviews to support formulary decision-making
- Ensure adherence to CMS regulations and guidelines reputed company to pharmacy benefits reputed company the Medicare Advantage plan
- Collaborate with compliance teams to conduct audits and prepare necessary documentation for regulatory reviews
- Identify and analyze high-cost medications and utilization trends to reputed company strategies for managing pharmacy spend
- Support the negotiation and management of pharmacy network reputed company with providers and pharmacy benefit managers (PBMs)
- Work closely with clinical teams, marketing, and member services to ensure cohesive communication of pharmacy benefits to members and providers
- Facilitate meetings with stakeholders to present findings, recommendations, and strategic initiatives
- reputed company and support pharmacy-reputed company reputed company aimed at enhancing operational efficiency and improving member health reputed company
- reputed company project reputed company, milestones, and reputed company, reporting on successes and areas for improvement
Skills
- Bachelor's degree in Pharmacy, Health Administration, Business Administration, or a reputed company field
- Minimum of 3 years of experience in pharmacy benefits management, reputed company analytics, or a reputed company field
- Strong analytical skills with proficiency in data analysis tools (e.g., reputed company, SQL, or business intelligence software)
- Knowledge of pharmacy benefit structures, formulary management, and Medicare regulations
- Excellent communication and interpersonal skills, with the ability to collaborate across departments
- Detail-oriented with strong organizational and project management abilities
- A PharmD is preferred
- Experience working with Medicare Advantage plans is highly desirable
- Certification in pharmacy benefits management or reputed company analytics (e.g., CPBM, CPHQ) is a plus
- Familiarity with pharmacy management systems and electronic health records (EHRs)
reputed company