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Business Analyst - Pharmacy Solutions

Job ID: 11744
Location: Morrisville, NC
Facility/Division: Health Alliance
Status: Full Time
Shift: Day Job

Did you know UNC Health has Ranked #2 Most Trusted Healthcare Brand in the U.S.? The UNC Health brand was ranked as the #4 healthcare brand in the United States overall and the #2 most trusted healthcare brand, just after Johns Hopkins and before Mass General. Join our One-Great-Team!

Job Description

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

 Job Summary: 

The Pharmacy Solutions Analyst is responsible for a full range pharmacy benefit and clinical pharmacy project and operational support. These initiatives ensures operational effectiveness and excellence of the Managed Pharmacy Solutions (MPS) portfolio. This is a collaborative, dynamic role requiring critical thinking skills, independence, strategic mindset, attention to detail, and an ability to multi-task in a fast-paced environment. The position collaborates with operational teams to develop action plans for improving program performance with analytics, finance, and operations. This is a telecommuting position with occasional onsite work from our Morrisville, NC office. 

Description of Job Responsibilities: 

Project Support 

  • Provide project management support for operational initiatives that have impact on clients or vendors 
  • Investigates non-standard requests and problems, with some assistance from others 
  • Assists with tracking and trending of specified quality metrics including but not limited to HEDIS and other quality reporting as required 
  • Support report/dashboard distribution and day-to-day operation by developing the process, structure, methodologies, standards, guides, and SOPs. 
  • Must be able to run and troubleshoot reports/queries, reconcile data, and identify discrepancies in either raw or final data. 
  • Creates performance reports, dashboards & views for MPS leadership 
  • Work with Quality teams to develop reporting requirements that align with NCQA and URAC 
  • Develop standard reports and custom reports as needed 

Client Support 

  • Assist in preparation and analysis of data related to client pharmacy contract obligations 
  • Audit Client Benefit Set Up 

Temporary Implementation Support that includes but is not limited to : 

  • Ensure all implementation items are tracked, documented, and closed, in agreement with client intent. 
  • Provide timely and appropriate input to ensure implementations are on track for successful service and go live readiness. 
  • Develop and maintain strong interdepartmental relations and communication as it specifically relates to managed accounts including finance, IT, legal, sales, data, clinical and other departments as needed, to establish an understanding of client needs for implementation and ongoing services. 
  • Validate account set up in the current claims system to ensure adherence to plan documents. 
  • Schedule and lead Implementation meeting with new clients. 
  • Complete internal document with required data gathered from the Implementation meeting. 
  • Determine how enrollment and eligibility information will be provided. 
  • Verify and clarify all information leading to preparation of new plan administration and benefits design. 
  • Provide internal documentation of client's plan design/administrative plan to all internal parties. 
  • Schedule and chair internal departmental meetings to review new client plan design. 
  • Perform other duties as assigned 

Other Information

Education Requirements:
● Bachelor’s degree in Business Administration, Economics, Finance, Public Administration or related field (or equivalent combination of education, training and experience).
Licensure/Certification Requirements:
● No licensure or certification required.
Professional Experience Requirements:
● If a Bachelor's degree: Two (2) years of experience in professional accounting, management of an operational unit, business analysis or financial analysis.
● If an Associate's degree: Six (6) years of experience in professional accounting, management of an operational unit, business analysis or financial analysis.
● If a High School diploma or GED: Ten (10) years of experience in professional accounting, management of an operational unit, business analysis or financial analysis.
Knowledge/Skills/and Abilities Requirements:


Job Details

Legal Employer: STATE

Entity: Health Alliance

Organization Unit: Population Value Care Pharmacy 

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Schedule: Day Job

Location of Job: US:NC:Morrisville

Exempt From Overtime: Exempt: Yes



This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care. This is not a State employed position.
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Diversity Statement

The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.

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