Senior Business Analyst-Managed Care Pharmacy (Remote)
JOB SUMMARY/PURPOSE
Responsible for reviewing assigned business processes from end-to-end to identify and address operational, clinical, financial and technological risks. Identifies opportunities to improve efficiency. Responsibilities include full range of activities from leading small to large scale projects to assisting other project managers on complex interdepartmental projects related to organization operational business functions that affect team members and providers at the industry level.
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
Bachelors degree required. Masters degree preferred.
Four (4) years business analysis and/or business systems analysis project coordination related experience required. A Masters degree in a related field may be substituted for two (2) years experience.
Experience working on large scale projects as well as handling day-to-day operational requests from the business required.
Advanced experience and/or training in SQL and Microsoft Excel required.
Pharmacy Data Focus
Strong knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization
Proficiency with computer software programs, e.g. MS Outlook, Word, PowerPoint and Visio
Advanced Proficiency with MS Excel for data tracking, manipulation, formulas, and creating pivot tables, graphs and charts, and other advanced functions required
Competency using business intelligence platforms (e.g., Tableau, Power BI) for data blending, joining, and other advanced functions to implement complex business logic
Ability to critically evaluate information gathered from multiple sources
Ability to analyze large data sets using tools such as SQL/SAS/SPSS
Ability to design and review pharmacy claims analysis/reports according to specific project requirements; and ability to prepare narrative reports
Ability to read, analyze, and interpret technical procedures, or governmental regulations
KNOWLEDGE/SKILLS/ABILITIES
Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 100% of the time)
CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
PI255910749
Apply Now
Responsible for reviewing assigned business processes from end-to-end to identify and address operational, clinical, financial and technological risks. Identifies opportunities to improve efficiency. Responsibilities include full range of activities from leading small to large scale projects to assisting other project managers on complex interdepartmental projects related to organization operational business functions that affect team members and providers at the industry level.
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
Bachelors degree required. Masters degree preferred.
Four (4) years business analysis and/or business systems analysis project coordination related experience required. A Masters degree in a related field may be substituted for two (2) years experience.
Experience working on large scale projects as well as handling day-to-day operational requests from the business required.
Advanced experience and/or training in SQL and Microsoft Excel required.
Pharmacy Data Focus
Strong knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization
Proficiency with computer software programs, e.g. MS Outlook, Word, PowerPoint and Visio
Advanced Proficiency with MS Excel for data tracking, manipulation, formulas, and creating pivot tables, graphs and charts, and other advanced functions required
Competency using business intelligence platforms (e.g., Tableau, Power BI) for data blending, joining, and other advanced functions to implement complex business logic
Ability to critically evaluate information gathered from multiple sources
Ability to analyze large data sets using tools such as SQL/SAS/SPSS
Ability to design and review pharmacy claims analysis/reports according to specific project requirements; and ability to prepare narrative reports
Ability to read, analyze, and interpret technical procedures, or governmental regulations
KNOWLEDGE/SKILLS/ABILITIES
Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 100% of the time)
CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
PI255910749
Apply Now