Pharmacy Analytics Manager; CMH Health

Position: Pharmacy Benefits Analytics Manager (CMH Health)

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Individua(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.

Milliman’s CMH Health practice is seeking a Pharmacy Benefits Analytics Manager to work in a fast-growing area of the Health practice. This role will involve accurately diagnosing client problems, developing project proposals, refining project strategy, outlining a project plan, managing internal resources, and presenting the results to the client. The Pharmacy Benefits Analytics Manager may assist clients such as employers, health plans, PBMs, and pharmaceutical companies.

Who

We Are

Independent for 75 years, Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world’s most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.

Job Responsibilities

• Provide qualitative and financial evaluations of PBM contracts, including pricing and fee schedules
• Assist with developing models to conduct detailed analyses of pharmacy data, including pharmacy claims, eligibility data, etc.
• Acquire, standardize, and merge various data sets to provide summarized reports
• Contribute to drafting proposals, presentations, exhibits, RFPs, and reports
• Manage client relationships, projects, assignments, presentations, and deliverables
• Be able to work independently, but also actively lead teams utilizing pharmacy data expertise on various projects

Potential projects could include

• Trend Related Modeling and Analysis
• Analyzing pharmacy data to provide innovative pricing solutions
• Medicare Part D, Medicaid, and Commercial Pharmacy Formulary and Pricing Analysis
• Medicare Part D Fraud, Waste, and Abuse Monitoring
• Evaluation of New Product Pipeline (e.g., evaluating impact of agents for NASH, oncology drugs, etc.)
• Pharmaceutical Company Strategy Support (e.g., analytics to support formulary negotiations and modeling)

Minimum Requirements

• Bachelor’s degree required
• A minimum of four years of experience in the pharmacy industry (ex. PBM, health plan, retail pharmacy etc.)
• Extensive knowledge of pharmacy claims reimbursement (ex. WAC, AWP, discounts, rebates, etc.)
• Experience with handling large pharmacy claims datasets
• Experience creating models and reports focused on opportunities for formulary management, prior authorizations, drug pricing, etc.
• Strong business software capabilities, especially with Microsoft office tools (Excel) and data analysis technologies (SAS/SQL)

Competencies and Behaviors that Support Success in this Role

• Analytical thinking and the ability to evaluate analyses for downstream impact
• Creative problem solving and analytical skills.
• Superior verbal and written communication skills
• Client focused and results oriented
• Ability to work independently and in a team environment
• Self-motivated, creative, and resourceful

The Team

Milliman is one of the leading experts in healthcare financing and delivery. We advise clients on a wide range of issues—from assessing the impact of healthcare reform on organizations or populations to streamlining operations while advancing the quality of patient care. Our consulting work is supported by a powerful toolkit of data analytics solutions and informed by the most trusted, comprehensive set of cost guidelines in the industry.

Through a team of professionals ranging from actuaries to clinicians, technology specialists to plan administrators, we offer unparalleled expertise in employee benefits, investment consulting, healthcare, life insurance and financial services, and property and casualty insurance.

Salary

The overall salary range for this role is $117,500 - $222,985.

For Candidates Residing In

• $135,125 - $222,985

All Other States

• $117,500 - $193,900

A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc.

Location

It is preferred that…