Conduct rigorous quantitative and qualitative analysis of our pharmacy offering, including utilization trends, clinical outcomes and cost drivers; synthesize findings into clear insights and recommendations.
Develop and maintain dashboards and reporting that translates complex pharmacy data into actionable insights for leadership, ensuring accuracy and transparency.
Monitor PBM performance against contractual guarantees, including rebates, administrative fees, pricing and discount guarantees, network access, and operational service levels; identify variances and support issue resolution.
Provide analytical oversight of additional pharmacy vendors, ensuring performance aligns with service agreements, clinical standards, and financial expectations.
Analyze overall pharmacy spend and conduct deep dives into utilization and trend drivers, including specialty drug impact, to identify clinical optimization and cost-containment opportunities.
Support cost projections, forecasting, and ROI analysis for strategic pharmacy initiatives, benefit design changes, coverage updates and other program changes; partner closely with Actuarial and Finance on budgeting and financial oversight.
Serve as the primary subject-matter expert for PBM data, reporting, and data validation, ensuring the integrity and reliability of vendor-provided information.
Lead pharmacy regulatory reporting processes and support compliance with all applicable federal and state requirements.
Partner with cross-functional teams including Finance, Medical Economics, Clinical, Account Management, Compliance and others.

Requirements

5+ years experience in pharmacy analytics, PBM oversight, consulting, or a related area
Expertise in analyzing pharmacy claims data, drug cost trends and formulary utilization
Deep understanding of PBM contracts, pricing methodologies and rebate structures
Advanced proficiency in Excel, SQL and Tableau
Ability to interpret complex pharmacy data and communicate insights clearly

Benefits

alternative medicine coverage
generous PTO
up to 16 weeks paid parental leave
paid holidays
401k program
transportation perks
education reimbursement
paid paw-ternity leave

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills

pharmacy analyticsPBM oversightdata analysiscost projectionsforecastingROI analysisdata validationclinical optimizationutilization analysisformulary utilization

Soft skills

communicationanalytical oversightissue resolutioncollaborationinsight synthesisleadership