Pharmacy Analytics Consultant I/II

Job Description The Pharmacy Analytics Consultant provides direct support for both Pharmacy and Medical Drug information needs using a variety of analytic tools and applications. The Consultant works with internal and external stakeholders and management to achieve Pharmacy Markets strategy, growth, compliance, and affordability objectives across the enterprise. The analyst collaborates with multidisciplinary teams (clinical, financial, sales, and Line of Business Leaders) to recommend actionable items leading to positive pharmacy financial performance. This position prepares and presents information to enable senior management and customers to better understand, evaluate, and support their goals. Accountabilities Level I Perform research on projects and manage and lead projects to meet business objectives from across the enterprise. Analyze data to determine business problems, trends, or opportunities for process improvements. Provide consultation and analytic support within the Pharmacy Division, other Health Plan departments, and external vendors to ensure the most effective and affordable Pharmacy Benefit. Identify needs to develop new and innovative Pharmacy products, perform appropriate research, analyses, and evaluate feasibility of their administration and implementation. Communicate effectively with all levels of the organization related to health plan cost, utilization trends, and savings strategies. Articulate results, insights, and recommendations to management, steering committees, and project sponsors. Develop and deliver actionable insights to key enterprise stakeholders; actively participate in collaborative meetings with internal and external partners. In partnership with Sales, Finance, and Actuarial conduct comparative pricing analyses for pharmacy benefit Requests for Proposal. Provide analytics to support strategy development and innovative programs that align with enterprise and pharmacy goals and objectives. Partner with business units to ensure compliance with governmental, contractual, corporate guidelines, and regulations; participate in all CMS and DOH compliance audits. Develop and establish standardized reporting and processes to support maintenance of business activities. Stay current with Health Plans tools and data sources/structures to accurately pull and deliver data; regularly review trends and best practices related to healthcare analytics. Compile complex data sets tailored to customers’ needs; evaluate and process raw data for user‑friendly delivery and actionable insight. Consult with other analytical units (e.g., Business Intelligence) to develop automated production reports, dashboards, and cubes for efficiency when appropriate. Engage with external partners and customers (Employer Groups, Brokers, Consultants, Providers, Vendors) to drive the success of Health Plan partnerships and goals. Enhance Pharmacy knowledge and consulting skills to contribute to affordability and savings for the Enterprise and customers. Create unified strategies with internal departments that target reducing costs of healthcare. Manage, organize, and prioritize tasks for multiple projects with competing deadlines to successful completion. Collaborate with team members, leveraging skill sets across the team and aiding in growth and development as needed. Proactively problem‑solve, investigate, and bring concerns to management or business partners regarding data pulls and analyses, as appropriate. Build collaborative relationships across functional teams and other analytic teams across the organization. Demonstrate high standards of integrity and support the Lifetime Healthcare Companies’ mission, values, Corporate Code of Conduct, and Lifetime Way values and beliefs. Maintain high regard for member privacy in accordance with corporate privacy policies and procedures. Show regular and reliable attendance. Perform other functions as assigned by management. Level II (in addition to Level I Accountabilities) Assist in training and mentoring fellow analysts. Participate and represent as a subject matter expert (SME) in cross‑sectional team meetings or with business partner leads or other departments as needed. Participate on departmental and Health Plan project teams to recommend and/or develop comprehensive data strategies for optimal SAS/BI Tool utilization and connectivity with other BI tools. Devises strategy for producing deliverables, selecting and utilizing the most appropriate analytic tool, and building process efficiencies. Level III (in addition to Level II Accountabilities) Utilize all relevant tools that optimize reporting efficiency for consumption by business partners and/or provide user‑friendly tools for self‑service repetitive reports. Leverage knowledge of claims data sets/warehouses and Medical/Pharmacy Management systems to produce reports that illuminate health plan and provider partner program effectiveness. Contribute, in partnership with Data Science, to develop predictive cost savings models and quantify the value and impact of department management programs for business use to both external and internal partners. Provide expertise in relational database concepts to analytics areas and customers. Seek opportunities to train and mentor analysts within the department framework. Demonstrate keen judgment on involved and complex assignments; devise methods and procedures to meet unusual conditions and make original contributions to solving difficult problems. Level IV (in addition to Level III Accountabilities) Recommend advanced analytic models and research that financially impact pricing, cost containment, quality, marketing, and risk management functions. Develop large, complex advanced analytic models and perform data mining to identify trends or opportunities for improved outcomes. Provide consultation, complex performance analysis, and coaching expertise to team members around continuous quality improvement methods. Foster a culture of continuous improvement that uses performance data to understand healthcare cost and utilization trends, clinical and condition management analysis, data quality measurement, and predictive modeling. Improve visual analytics throughout the organization. Interact with Health Plan leadership to interpret model output and make business inferences that address strategic needs. Assess need and opportunity for upgrades to existing or new analytic products (e.g., SAS or Cognos). Prepare and submit studies for journal publication or national meeting presentation, as needed. Minimum Qualifications All Levels Bachelor’s degree in Mathematics, Statistics, Medical Informatics, Economics, or related field preferred; alternatively, a minimum of two related years’ experience in data or information analysis and reporting. Knowledge and applicable use of all tools available to develop analyses, extract information, and use the most appropriate tool for each report (e.g., SAS, Cognos, Excel, Access, SPSS, DataFlux, AQT, Winscp, PuTTY). Proficiency in SAS and/or Cognos and Microsoft tools. Working knowledge of Microsoft Office Suite. Knowledge of basic statistical concepts and strong analytical and problem‑solving skills with attention to detail. Ability to simplify complex data sets for all audiences, highlighting significant impacts or potential areas for program development. Willingness to develop relationships with partners within the health plan to understand data requests and shape influential impact. Intermediate understanding of healthcare products and operational business knowledge. Analytic abilities combined with the capacity to complete projects with minimal supervision. Experience with physician or hospital claims/group data and in‑depth product and member knowledge preferred. Excellent oral and written communication skills. High degree of initiative, proactive attitude, and commitment to teamwork. Ability to relate to internal and external customers effectively and tactfully. Collaborative work with requestors and business partners; adaptability to industry change and changing priorities. Level II (in addition to Level I Qualifications) Minimum of three years’ analytic experience in the healthcare industry. Knowledge of advanced statistical concepts and strong analytical and problem‑solving skills. Effectively interact with internal and external customers and translate user information needs into requirements. Ability to work with large datasets (2TB or greater) and integrate across multiple structured and unstructured sources. Strong PC/programming skills including Microsoft Office Suite, VBA, SQL, PowerPlay, Impromptu, and moderate proficiency in SAS. Consistent high quality and accuracy in work. Self‑motivation, initiative, and ability to perform under pressure with little supervision. Level III (in addition to Level II Qualifications) Minimum of five years’ experience using statistical concepts and tools. Master’s Degree with at least two years of statistical analysis experience preferred. Expertise in relational database concepts. Advanced statistical capabilities, data mining, forecasting, predictive modeling skills, and/or actuarial techniques. Skills in quality principles, root cause analysis, and problem solving. Business and technical problem‑solving skills. Extensive experience in analytic tools (e.g., SAS, Cognos, SPSS). Level IV (in addition to Level III Qualifications) Minimum of three years’ health‑care predictive modeling experience or seven years in health informatics. MS or MA in Statistics, Economics, or related discipline preferred. Ability to create, develop, and validate models independently. SAS Base Certification required; SAS Advanced Certification preferred or equivalent certification. Project Management/Process Improvement knowledge preferred. Continued professional growth in analytic software tools (e.g., SAS competency evidence from Advanced Certification Exam or Certified Predictive Modeler Exam). PMP or Six Sigma project management experience desired. Advanced analytic software programming proficiency required (e.g., SAS EBI suite, Information Maps, Stored Processes, Web Report Studio, Information Delivery Portal). Physical Requirements Work prolonged periods sitting at a workstation, using a computer. Work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse, or phone for three or more hours at a time. Typical office environment with fluorescent lighting. Work in a home office for continuous periods for business continuity. Travel across the Health Plan service region for meetings and/or training as needed. Compensation E1: $62,400 - $84,000 E3: $240,000 - $106,929 The salary range shown is the minimum and maximum for this position. Actual salary will vary based on factors such as budget, experience, knowledge, skill, and education. The range reflects one component of the total rewards package, which may include group health/dental insurance, retirement plan, wellness program, paid time away, and paid holidays. Equal Opportunity Employer All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Americans with Disabilities Act Statement In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. #J-18808-Ljbffr