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Business Operations Analyst - Pharmacy Solutions Analysis Pharmacy Benefits

This job posting is no longer active.

Job ID: 11769
Location: Morrisville, NC
Facility/Division: Shared Services
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


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 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:

Operational Support

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.

Client Support

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

Project Management

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. 

Other Information

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.

If Associate's degree, nine (9) years of experience in business analysis, financial management or financial analysis.
If high school/GED, thirteen (13) years of experience in business analysis, financial management or financial analysis.

, Modified, Modified

Job Details

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

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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