The selected candidate will independently provide advanced analytics to support understanding and improvement of pharmacy benefit utilization, cost, quality, and clinical outcomes. This role develops analytic attributes related to pharmacy utilization management, drug cost optimization, formulary performance, medication adherence, and provider/member pharmacy engagement.The Senior Healthcare Informatics Analyst - Pharmacy Analytics independently designs and delivers analytics that improve how pharmacy services are valued, utilized, and provided. This role develops patient and provider level analytics including pharmacy utilization and outcomes, medication adherence and persistence, formulary and rebate optimization, pharmacy cost management, and pharmacy driven quality measures.ACCOUNTABILITIES AND ESSENTIAL FUNCTIONSLeads the selection and application of pharmacy focused analytic, evaluation, and BI methodologies to support business decisions and strategic planningLeverages pharmacy claims data, PBM feeds, EDW data sources, and non EDW datasets to deliver actionable insightsTranslates pharmacy business rules and policies into analytical models and reporting solutions, acting as a liaison between Pharmacy, Analytics, IT, and EIM teamsRequired SkillsBachelors degree in healthcare administration, pharmacy, public health, statistics, economics, analytics, computer science, or related field required. Master-s degree in a related field preferred. Four years of related experience may substitute for a Bachelor-s degree. A Master-s degree may substitute for two years of required experience; a Doctorate may substitute for an additional two years4 years of healthcare analytics experience, with pharmacy or PBM analytics experienceExperience analyzing pharmacy claims, formulary performance, drug mix, utilization trends, rebates, and adherence metrics (PDC/MPR)Advanced knowledge of SAS (including Enterprise Miner)Strong working knowledge of the U.S. healthcare system in a payer setting, with specific understanding of pharmacy benefits and PBM operations Ability to translate complex pharmacy analytics into clear insights for executive, clinical, and technical audiencesTechnical Skills:Proficiency with SQL, SAS, R, Python, Tableau, or similar analytic/visualization toolsDomain Expertise (Desired): Pharmacy pricing and payment methodologies (AWP, WAC, MAC, rebates, trend drivers)Population health and pharmacy driven interventionsClinical groupers and classification systems including GPI, NDC, therapeutic class, DRG, HCC, and related modelsPharmacy related quality metrics (HEDIS medication measures, STAR ratings)Knowledge of commercial and Medicare Advantage pharmacy optimization is a plusInterested candidates can send your resumes to satya@mind-wareinc.com and call me @ 651-964-4775
14 days ago