At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Health Data Analyst (Pharmacy Claims Audit) - Remote
Job Description
The Health Data Analyst provides information, analyses, and consultation to internal and external stakeholders. This position assesses the performance of pharmacy benefits and/or networks and develops recommendations for improvements or enhancement to support departmental and organizational objectives. This position will participate in the development of new reports, analytical models, and products/benefit programs that align with Prime's strategic imperatives.
Responsibilities
- Assumes responsibility for moderately complex analytic and consultative work such as analyzing and interpreting client pharmacy benefit data, trends and reports and partnering with analytics team to deliver recommendations or project status updates to internal and external stakeholders; investigates follow up items or questions regarding project and/or request scope
- Investigates key drivers of benefit performance
- Create new queries using SASEG including multiple table joins, understanding of table structures, creation of detailed formulas leveraging an understanding of SAS code
- Participates in development of analytic methodologies, models, reports and new products
- May be responsible for Centers for Medicaid/Medicare Services reporting and analysis, including the management of directories and bid support
- Other duties as assigned
Minimum Qualifications
- Bachelor's degree in Mathematics, Finance, or related field, or the equivalent combination of education and/or relevant work experience; HS diploma or GED is required
- 2 years of experience in pharmacy benefits management, reporting & analytics, benefits consulting, healthcare, financial services or related field
- Must be eligible to work in the United States without need for work visa or residency sponsorship
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
- Advanced Microsoft Excel skills – ability to create complete formulas and efficient data manipulation.
- Extensive experience using analytic tools; familiarity with Alteryx and Cognos
- Experience working with pharmacy audit and/or fraud waste, and abuse
- Intermediate troubleshooting skills, including in-depth client da