Senior Analyst, Government Pricing

Role Description

Due to growth, we are adding a Sr. Analyst, Government Pricing to our team. The Sr. Analyst, Government Pricing is responsible for advanced analytical support of Medicaid FFS pharmacy programs, including:

• MAC pricing
• 340B program impacts
• Statement of Work (SOW)–driven cost analysis

This role evaluates pricing methodologies, utilization trends, and regulatory impacts to support accurate forecasting, program strategy, and client/vendor decision-making. The Sr. Analyst, Government Pricing will:

• Develop and maintain cost and predictive trending models by SOW segment
• Supervise core analytical work related to Medicaid MAC and 340B
• Ensure the accurate ingestion, validation, and application of external pricing files
• Support cross-functional and vendor partnerships to deliver compliant, data-driven Medicaid pricing outcomes

Qualifications

• Bachelor’s degree in Finance, Economics, Healthcare Administration, Data Analytics, or related field, or equivalent work experience, required
• 5+ years of experience in PBM, Medicaid pharmacy programs, managed care, healthcare analytics, or pricing analysis required
• Experience supporting Medicaid fee-for-service drug pricing methodologies in alignment with federal and state Medicaid requirements required
• Experience preparing documentation, reporting, and analysis to support internal reviews, regulatory inquiries, audits, and client requests required
• Experience working with industry pricing and reference sources, including Medi Span multisource and product codes (e.g., MONY indicators), NADAC pricing files, and HRSA 340B ceiling price data required
• Experience conducting pricing impact analyses and maintaining financial models to support Medicaid Statements of Work (SOWs), amendments, and renewals required
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees

Requirements

• Supports the development and maintenance of Medicaid Fee-for-Service pharmacy pricing and modeling aligned with the company’s mission, strategies, products, and services
• Oversee core analytical work related to SOW requirements, including Medicaid MAC pricing analysis, and 340B program impacts and compliance considerations
• Develop, maintain, and enhance cost analysis and predictive trending models to support Medicaid FFS programs, segmented by SOW, pricing methodology, or program initiative
• Lead and manage the capture, ingestion, and maintenance of external pricing files (e.g., NADAC, state MAC files, other benchmarks)
• Create and maintain a formal Tier 2 inquiry process for MAC-related issues
• Collaborate with other leaders to interpret and apply Medicaid regulations, state-specific requirements, and program initiatives
• Collaborate with internal stakeholders (e.g., Client Services, Contracting, Operations, Compliance) to evaluate the financial and contractual impact of Medicaid pricing and program decisions
• Interact with external stakeholders and vendors, building collaborative relationships to support pricing accuracy, data transparency, and program execution
• Support leadership with ad hoc analysis, forecasting, and scenario modeling related to Medicaid FFS pricing, program changes, and regulatory developments
• Assist leadership in supporting new Medicaid program initiatives, enhancements to pricing methodologies, and expansion of analytical capabilities
• Contribute to the development of client- or state-facing materials and presentations, as needed
• Periodic and detailed reporting of activities and opportunities to leadership
• Other duties as assigned

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!