Director of Pharmacy Analytics
UNITE HERE HEALTH serves over 200,000 workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!
We are looking for a Director of Pharmacy Analytics to prepare, develop, and assist in development of reporting and analytics associated with Pharmacy/Drug benefits. The position assists with maintenance and implementation of clinical edits and formulary documents with approval from clinical staff. This position has oversight of Analysts in the Pharmacy Analytics area.
ESSENTIAL JOB FUNCTIONS AND DUTIES
• Collects, maintains, edits, and organizes data necessary to prepare periodic reports on Pharmacy/Drug benefits
• Develops and prepares special and ad hoc reports requested by internal parties related to Pharmacy/Drugs and assist clinical staff in making data driven decisions
• Assists in maintenance and development of the Enterprise Data Warehouse (EDW) for Pharmacy data
• Engages with consultants as needed and provides requested information
• Strategizes with senior leadership regarding initiatives to continue to keep overall drug spend down
• Assists in development of Pharmacy/Drug benefit EDW reporting
• Collaborates with other departments in maintaining and providing Pharmacy benefit information (e.g., Analytics, Legal, Finance)
• Assists with external Pharmacy reporting/analytics projects
• Works with external contacts to complete requests or projects
• Assists in maintaining, editing, and implementing clinical edits and formulary files as needed
• Manages in development and implementation of Annual Transparency Reporting requirements
• Maintains database for drug lookup tool
• Oversees or works with Analytics staff and provides support and training
• Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints
• Supervises, leads, and delegates work and coaches, mentors, develops employees
• Anticipates and analyzes problems, identifies, and develops alternative solutions, projects consequences of proposed actions, and implements recommendation/solutions
• Track annual progress of OOP accumulators and annual/lifetime Plan maximums; provide communication to impacted members when needed
• Owns reports for Trustee/Manager Meetings with appropriate data analysis
• Prepare Plan summaries for determination of creditable coverage status, file annual CMS creditable coverage disclosure
• Oversees reporting and collection of rebate guarantees
• Anticipates potential issues with vendors not meeting agreed upon performance guarantees in the areas of rebates and copay assistance
• Recommends hires and promotions, directs, and evaluates employment decisions for all assigned positions
• Reinforces the development and coordination of policies and procedures
• Owns the oversight of continued employee training requirements, safety, and quality initiatives
• Exemplifies the Fund’s BETTER Values and Professional Effectiveness Dimensions in leading and fostering a respectful, trusting, and engaged culture of diversity and inclusion
ESSENTIAL QUALIFICATIONS
• 7 ~ 10 years of direct experience minimum, some of which is working in a PBM organization, or related field
• Bachelor's degree in business Analysis or related field or equivalent work experience required
• 5 ~ 7 years of supervisor experience required
• Expert knowledge and experience performing analytics and reporting
• Experience with design of reporting formats
• Working knowledge of industry coding (revenue codes, International Classification of Diseases (ICD) 9 or 10’s, Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT) codes, Medispan, etc.)
• Working knowledge of SQL
• Advanced level Power BI skills and application
• Advanced level Microsoft Office skills (PowerPoint, Word, Access, Outlook)
• Advanced level Microsoft Excel skills
• Advanced level system(s) skills in SQL
Salary range for this position: Salary $137,200~$174,900. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.
Work Schedule (may vary to meet business needs): Monday thru Friday, 7.5 hours per day (37.5 hours per week) as a remote employee (central time zone preferred).
We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).
#LI-REMOTE
Apply Now
Apply Now
We are looking for a Director of Pharmacy Analytics to prepare, develop, and assist in development of reporting and analytics associated with Pharmacy/Drug benefits. The position assists with maintenance and implementation of clinical edits and formulary documents with approval from clinical staff. This position has oversight of Analysts in the Pharmacy Analytics area.
ESSENTIAL JOB FUNCTIONS AND DUTIES
• Collects, maintains, edits, and organizes data necessary to prepare periodic reports on Pharmacy/Drug benefits
• Develops and prepares special and ad hoc reports requested by internal parties related to Pharmacy/Drugs and assist clinical staff in making data driven decisions
• Assists in maintenance and development of the Enterprise Data Warehouse (EDW) for Pharmacy data
• Engages with consultants as needed and provides requested information
• Strategizes with senior leadership regarding initiatives to continue to keep overall drug spend down
• Assists in development of Pharmacy/Drug benefit EDW reporting
• Collaborates with other departments in maintaining and providing Pharmacy benefit information (e.g., Analytics, Legal, Finance)
• Assists with external Pharmacy reporting/analytics projects
• Works with external contacts to complete requests or projects
• Assists in maintaining, editing, and implementing clinical edits and formulary files as needed
• Manages in development and implementation of Annual Transparency Reporting requirements
• Maintains database for drug lookup tool
• Oversees or works with Analytics staff and provides support and training
• Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints
• Supervises, leads, and delegates work and coaches, mentors, develops employees
• Anticipates and analyzes problems, identifies, and develops alternative solutions, projects consequences of proposed actions, and implements recommendation/solutions
• Track annual progress of OOP accumulators and annual/lifetime Plan maximums; provide communication to impacted members when needed
• Owns reports for Trustee/Manager Meetings with appropriate data analysis
• Prepare Plan summaries for determination of creditable coverage status, file annual CMS creditable coverage disclosure
• Oversees reporting and collection of rebate guarantees
• Anticipates potential issues with vendors not meeting agreed upon performance guarantees in the areas of rebates and copay assistance
• Recommends hires and promotions, directs, and evaluates employment decisions for all assigned positions
• Reinforces the development and coordination of policies and procedures
• Owns the oversight of continued employee training requirements, safety, and quality initiatives
• Exemplifies the Fund’s BETTER Values and Professional Effectiveness Dimensions in leading and fostering a respectful, trusting, and engaged culture of diversity and inclusion
ESSENTIAL QUALIFICATIONS
• 7 ~ 10 years of direct experience minimum, some of which is working in a PBM organization, or related field
• Bachelor's degree in business Analysis or related field or equivalent work experience required
• 5 ~ 7 years of supervisor experience required
• Expert knowledge and experience performing analytics and reporting
• Experience with design of reporting formats
• Working knowledge of industry coding (revenue codes, International Classification of Diseases (ICD) 9 or 10’s, Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT) codes, Medispan, etc.)
• Working knowledge of SQL
• Advanced level Power BI skills and application
• Advanced level Microsoft Office skills (PowerPoint, Word, Access, Outlook)
• Advanced level Microsoft Excel skills
• Advanced level system(s) skills in SQL
Salary range for this position: Salary $137,200~$174,900. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.
Work Schedule (may vary to meet business needs): Monday thru Friday, 7.5 hours per day (37.5 hours per week) as a remote employee (central time zone preferred).
We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).
#LI-REMOTE
Apply Now
Apply Now