Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Sr. Applied Stars and Quality Analytics AnalystJob Description
The Senior 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 develop new reports, analytical models, and products/benefit programs that align with Prime’s strategic imperatives and will lead high-complexity analysis and special projects as required.
Responsibilities
- Act as a champion of the consulting and analytic methodology for designated line of business; may provide work direction, serve as a mentor or train junior level analysts
- Develop analytic methodologies, models, reports and new products
- Lead complex client analytical work efforts and serve as an internal subject matter expert in designated line of business; leverages deep understanding of client or organizational drivers and maintains final accountability for client analytics and ad hoc reporting
- Proactively investigates and builds recommendations for enhancements or resolution regarding key drivers of benefit performance, trends and obstacles in order to improve overall benefit and/or network performance and provide effective consultation to internal and external stakeholders
- 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
- 5 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
Additional Qualifications
- Advanced troubleshooting skills, including in-depth client data research, which may involve research and drivers of utilization; understands resources needed and steps/processes on how to complete the problem; when issue arises, able to understand how to navigate to a resolution
- Strong PBM industry knowledge and knowledge of the financial levers of Prime; able to articulate the industry trends to clients and the impact of trends and changes to client financials
- Ability to establish rapport and effectively influence at all levels within an organization
- Ability to communicate effectively and present complex data to a wide variety of audiences
Preferred Qualifications
- PBM (Pharmacy Benefit Management) experience
- Experience conducting complex analysis on large sets of pharmacy, claims, medical, and/or financial data
- Basic to intermediate SAS coding skills
- Previous experience in a client facing or consultative role
- Extensive experience using analytic tools; familiarity with SAS EG
Minimum Physical Job Requirements
- Ability to travel up to 10% of the time
- Constantly required to sit, use hands to handle or feel, talk and hear
- Frequently required to reach with hands and arms
- Occasionally required to stand, walk and stoop, kneel, and crouch
- Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus
Reporting Structure
- Reports to Manager or Director in the Network Management, Consulting Analytics or Operations & Planning department
Potential pay for this position ranges from $81,000.00 - $138,000.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
Positions will be posted for a minimum of five consecutive workdays.
Top Skills
What We Do
Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.
In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US.
In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products:
• NetResults™
• Specialty Drug Management
• Best in Care™
• GuidedHealth®
• Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations
• Prime Analytics™
• CareCentered Contracting™Controlled Substance Management Program
Join us!
Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career.
At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact.
Follow Prime on LinkedIn to learn more.