Principal Pharmacy Analytics Lead

Role Description

Responsible for designing, building, validating, and operationalizing pharmacy performance analytics to improve medication adherence, Part D quality outcomes, and drug cost and utilization management. Serves as a senior, hands-on analytics builder and subject matter expert on Medicare Advantage pharmacy analytics, working independently to translate complex pharmacy, PBM/Rx claims, and health plan data into actionable performance insights. Directly impacts pharmacy strategy by building the analytic assets required to identify performance gaps, reduce manual reporting, and drive measurable improvement across all pharmacy objectives.

Primary Responsibilities

• Design, build, and maintain pharmacy analytic assets, including dashboards, data extracts, recurring performance views, and executive-ready reporting products across medication adherence, Part D quality, and cost trends.
• Translate pharmacy business requirements into auditable analytic logic, including adherence calculations, drug hierarchy assumptions, and opportunity sizing.
• Analyze multi-source data (PBM/Rx claims, medical claims, eligibility, clinical) to establish baselines, detect trends, and uncover root causes of performance gaps in areas like medication adherence and 90-day prescription adoption.
• Partner with Pharmacy, Clinical, Finance, and Operations stakeholders to prioritize high-impact opportunities and convert analytic insights into intervention targeting and measurable performance improvement.
• Automate and scale recurring pharmacy reporting to reduce manual effort through scalable dashboards, reusable SQL, documented logic, and repeatable processes.
• Create and manage validation routines, QA checks, and reconciliation processes to ensure pharmacy reporting is accurate, trusted, reproducible, and audit-ready.
• Translate complex pharmacy, PBM, and financial logic into clear, decision-ready performance narratives for non-technical stakeholders and health plan leadership.
• Serve as a senior subject matter expert on Medicare Advantage pharmacy analytics, PBM/Rx claims data, Part D quality measures, and formulary concepts.

Qualifications

• Bachelor's degree in Mathematics, Computer Science, Data Analytics, Public Health, Pharmacy, Health Informatics, or a related field; equivalent experience may be considered.
• 7+ years of healthcare analytics experience, with direct experience in pharmacy claims analytics, PBM/Rx data, Medicare Part D, medication adherence, or pharmacy performance analytics.
• Hands-on experience writing complex SQL and extracting data from large, multi-layered health plan data environments.
• Experience building dashboards, recurring reports, or automated reporting processes using Tableau, Power BI, or similar business intelligence tools.
• Experience with PBM data, Medicare Part D operations, medication adherence measures, pharmacy quality measures, or drug cost/utilization trends.
• Ability to translate pharmacy business questions into analytic rules, including member cohorts, adherence calculations, and stratification.
• Experience working with healthcare datasets such as PBM/Rx claims, medical claims, eligibility, or provider data.
• Demonstrated ability to self-direct analyses, manage ambiguity, structure complex problems, and deliver actionable insights with limited direction.
• Experience using AI-enabled analytics, automation, or natural language tools to accelerate insight generation.
• Strong communication skills with the ability to explain technical concepts and recommended actions to non-technical stakeholders.
• Advanced degree in Pharmacy, Public Health, Health Informatics, Analytics, Healthcare Administration, or a related field (e.g., PharmD, MPH, MS Analytics, MBA).

Requirements

• While performing the duties of this job, the employee works in normal office working conditions.
• Remote, USA
• Full time

Benefits

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities
• And much more...