Description
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.
Summary: The 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 Conduct comprehensive data reporting in pharmacy population health and quality metric measurement Managed Pharmacy Solutions/CAMP team to support decision making capabilities
Assists with tracking and trending of population health metrics including but not limited to PMPM spend, total cost of care, cost per case, population utilization, and care coordination activities
Assists with tracking and trending of specified quality metrics including but not limited to HEDIS and other quality reporting as required
Creates performance reports, dashboards & views for MPS leadership
Performs analyses evaluating the impact of various CAMP programs and clinical initiatives and provides regular summaries to relevant department and program leaders
The Population Health Management Analyst will gather health care data from a variety of environments, such as: public health data, electronic medical records, client feedback, and billing/claims data as available, and will segment and stratify as appropriate to describe various aspects of the population, e.g. high risk
The efforts of the PHM Analyst will position the organization to identify and respond to specific community needs and upcoming programmatic opportunities
Design and manage population health assessment reporting for a variety of populations served and managed by our Carolina Assessment of Medications Program (CAMP) team
Provide feedback on and insight into CAMP performance, with a specific focus on disease state specific programs
Work with Quality teams to develop reporting requirements that align with NCQA and URAC
Work with data management teams to develop standardized datasets used for the CAMP assessment reporting
Analyze, standardize and simplify data queries to ensure data consistency
Assist in periodic compilation and reporting of population health data (e.g. patient engagement, medication adherence, etc.)
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 medical electronic health record data and third party 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
Develop internal and external reports that summarize performance, identify outliers, and speak to corrective actions
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.
Develop and produce standardized reporting packages/tools
Client Support Assist in preparation and analysis of data related to client pharmacy contract obligations
Assist with financial responses to Request for Proposals (RFP)
Audit client financials
Assist with the development and formulation of pricing related programs for new and existing clients and provide analytical support for project work where needed
Perform other duties as assigned
Other Information Other information:
Education Requirements: ? Bachelor's degree in Business Administration, Economics, Finance, Public Administration or related field (or equivalent combination of education, training and experience).
Licensure/Certification Requirements: ? No licensure or certification required.
Professional Experience Requirements: ? If a Bachelor's degree: Two (2) years of experience in professional accounting, management of an operational unit, business analysis or financial analysis.
? If an Associate's degree: Six (6) years of experience in professional accounting, management of an operational unit, business analysis or financial analysis.
? If a High School diploma or GED: Ten (10) years of experience in professional accounting, management of an operational unit, business analysis or financial analysis.
Knowledge/Skills/and Abilities Requirements: Job Details Legal Employer: STATE
Entity: Health Alliance
Organization Unit: Population Value Care Pharmacy
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
