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Job ID: 11769
Location: Morrisville, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
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.
The Senior Pharmacy Solutions Analyst is responsible for a full range pharmacy benefit and clinical pharmacy analysis and data management support. These initiatives ensures operational effectiveness and excellence of the Managed Pharmacy Solutions (MPS) portfolio. They will track and analyze trends to make appropriate recommendations that will positively impact operational workflow, efficiencies, and client/plan performance. They will serve as a pharmacy data expert for MPS.
This is a telecommuting position with occasional onsite work from our Morrisville, NC office.
Description of Job Responsibilities:
This position will have to complete UM Data Analysis to provide insights into PA review TAT, consistency of decision, and overall trending, review pharmacy and medical claims analysis to identify trends in utilization, review pharmacy and medical claims analysis to identify gaps in care, and pharmacy and medical claims help manage drug spend and quality of care provided to members
Assist in preparation and analysis of data related to client plan(s) pharmacy operational performance, pharmacy contract obligations, mail order pharmacy and retail pharmacy networks, member eligibility and plan cost trends
Analyze, standardize and simplify data queries to ensure data consistency
Assist in periodic compilation and reporting of rebate and formulary data
Assist in maintenance and oversight of client/plan price lists
Assist with the development and formulation of pricing related programs for new and existing clients and provide analytical support for project work where needed
Assist in annual budgeting process for revenue costs, cost of sales, maintaining financial and operational dashboards, profitability metrics
Provide technical direction to operations staff for routine and non-routine issues
Analyze pharmacy claims data to provide leadership with key insights and findings
Work to integrate large amounts of data from multiple sources
Develop standard reports and custom reports as needed
The Analyst will utilize enterprise software and supportive BI tools to create timely and meaningful reporting (reports, dashboards, etc.) to meet the objectives set by the operational team(s)
Pulling and analyzing data on a regular basis to give leadership visibility to utilization, progress, and overall profitability
Design, develop, and implement data gathering and reporting methods and procedures for leadership, operations, and client services.
Create appropriate metrics/KPI's, reporting tools and dashboards that give insight into business performance and drive effective decision-making across all areas of Managed Pharmacy Solutions.
Build thoughtful data visualizations using Tableau (or other tools) to accelerate information-to-action at scale (for example, describing performance of KPI’s for leadership and helping operators on the front line take action towards. process/performance improvement); free up opportunity for root cause problem solving.
Prepare cost comparisons and savings analysis for prospective clients and future state planning
Assist with financial responses to Request for Proposals (RFP)
Audit client financials
Prepare business requirement documents and desk level procedures
He/she will then work with the operational teams to gain consensus on what the group as a whole needs, develop plans to meet those needs and then execute those plans to ensure customer satisfaction. He/she will follow-up with customers to ensure their needs are met. The position will also convene meetings with departmental staff to brainstorm needs related to staff productivity. He/she will develop plans to meet these needs and execute those plans. He/she will assist in developing staff benchmarks for productivity and ultimately will be able to prepare staffing models. The position will work with external vendors and other internal partners to determine the best way to produce the output for MPS Operational teams.
The analyst provides effective project management to clearly defines projects, develop project plans, and set priorities for working teams. Participate, lead or conduct project status meetings with key project stakeholders and Team members.
This position will work on multiple projects associated with data management for the team. The position will solicit data needs from other departments or customers to identify information needs.
EDUCATION REQUIREMENTS, Modified, ModifiedMaster's degree in Business Administration, Health Administration or related field or equivalent combination of education and experience.LICENSURE/CERTIFICATION REQUIREMENTS, Modified, ModifiedNo licensure or certification required.PROFESSIONAL EXPERIENCE REQUIREMENTS, Modified, Modified
, Modified, ModifiedIf Master's degree, one (1) year of experience in business analysis, financial management or financial analysis., Modified, ModifiedIf Bachelor's, Five (5) years of experience in business analysis, financial management or financial analysis.
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: HCS Pharmacy Benefit Mgt
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
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.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.