Pharmacy benefits is one of the fastest-growing segments of the healthcare industry, and pharmacy benefits management (PBM) arrangements can be extremely complicated. The CMH Health Milliman practice is seeking a Senior Pharmacy Benefits Analyst to work in a fast-growing area of the health practice to help support clients by helping them navigate the complex industry and provide data-driven solutions that can improve or lower the cost of care.
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.
The health practice is a high-performing environment with multiple subject matter experts, who work together to solve complex problems related to pharmacy benefits, reimbursement, supply, and strategy.
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
- Be able to work independently, but in a collaborative team environment
Minimum requirements
- Bachelor’s degree in pharmacy or data analytics related field
- At least two to six years of pharmacy claims analysis or similar experience
- Strong business software capabilities, especially with Microsoft office tools (Excel) and data analysis technologies (SAS/SQL)
- Experience in the pharmacy benefits industry (ex. PBM, health plan, etc.) preferred but not required
- Knowledge of pharmacy claims reimbursement (ex. WAC, AWP, discounts, rebates, etc.) preferred but not required
- Experience with handling large pharmacy claims datasets preferred but not required
- Experience creating models and reports focused on opportunities for formulary management, prior authorizations, drug pricing, etc. preferred but not required
Competencies and Behaviors that Support Success in this Role
- Experience working with large pharmacy claims data sets and development of custom reports
- 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 salary range is $55,000 to $85,000, depending on relevant factors, including but not limited to education, work experience, certifications, location, etc.
Location: It is preferred that this candidate work in-office at the Milwaukee, Chicago, or Harford office. Remote candidates will be considered.
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.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)