Pharmacy Data Analyst

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

**This position requires you to work onsite in Brooklyn, OH. on a hybrid basis.

Pharmacy Data Analyst I

Job Summary:

Under direct supervision, delivers analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Delivers analytic insights by conducting routine or standard quantitative analysis supporting strategic business decisions. Focuses on analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible. Primarily works indirectly with internal business customers.

Responsibilities:

• Applies analytics strategy and approach including routine or basic processes and analyses to deliver meaningful and actionable results as it relates to drug data, analytics, and reporting for medical drug and pharmacy management for clients and internal staff.
• Combines data from the enterprise data warehouse, pharmacy operational systems, and vendor outputs to deliver actionable insights with direct oversight and guidance from leadership.
• Publishes and communicates results in writing and verbally, ensuring timely and accurate reports are delivered to internal business partners.
• Creates documentation on all projects to ensure continuity and as a resource for future projects.
• Participates in internal and external audits and other projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as assigned by management.
• Collaborates on the creation and maintenance of tools, procedures, workflow, and data dictionaries.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required.
• Up to 1 year of professional work or educational project experience in analyzing data and basic statistics, preferably pharmacy data.

Professional Certification(s):

• NA

Technical Skills and Knowledge:

• Basic proficiency in data extraction and analytical programming languages (Python, R, SQL, Spark), data visualization (Power BI, Dash) and other analytical tools
• Basic knowledge of a cloud-based analytics platform (Azure databricks).
• Basic to intermediate Microsoft Office skills (word processing, spreadsheets, database reporting, presentation graphics).
• Good presentation skills; ability to put together brief deck displaying results.
• Basic knowledge of data mining, reporting, and reconciliation techniques and methodologies (e.g., machine learning, AI, etc.)
• Basic knowledge of the health insurance industry, and benefit and product designs.
• Basic knowledge of pharmacy claims, medical data, clinical programs.

Pharmacy Data Analyst II

Job Summary:

Under general supervision, delivers analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Delivers analytic insights by conducting routine or standard quantitative analysis supporting strategic business decisions. Focuses on analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible. Primarily works indirectly with internal business customers.

Responsibilities:

• Implements analytics strategy and approach including routine to intermediate processes and analyses to deliver meaningful and actionable results as it relates to drug data, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. Combines data from the enterprise data warehouse, pharmacy operational systems, and vendor outputs to deliver actionable insights with moderate to minimal level of guidance from leadership.
• Publishes and communicates results in writing and verbally, ensuring timely and accurate reports are delivered to internal business partners with general direction from leadership.
• Creates documentation on all projects to ensure continuity and as a resource for future projects.
• Supports data pulls and reviews as it pertains to internal and external audits and other projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as assigned by management.
• Collaborates on the creation and maintenance of tools, procedures, workflow, and data dictionaries.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required.
• 2 years of experience as a Pharmacy Data Analyst or equivalent experience analyzing data and statistics, preferably pharmacy data.

Professional Certification(s):

• NA

Technical Skills and Knowledge:

• Proficiency in data extraction and analytical programming languages (Python, R, SQL, Spark), data visualization (Power BI, Dash) and other analytical tools.
• Knowledge of a cloud-based analytics platform (Azure databricks).
• Intermediate Microsoft Office skills (word processing, spreadsheets, database reporting, presentation graphics).
• Good presentation skills; ability to put together brief deck displaying results.
• Knowledge of data mining, reporting, and reconciliation techniques and methodologies (e.g., machine learning, AI, etc.).
• Knowledge of the health insurance industry, and benefit and product designs.
• Knowledge of pharmacy claims, medical data, clinical programs.

Pharmacy Data Analyst III

Job Summary:

Under limited supervision, designs and executes analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Develops new analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible.

Responsibilities:

• Plans, develops, and implements drug data consultation, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. Creates and maintains a standard reporting package that reflects the Company's value to customers. Acts as subject matter expert (SME) to internal customers with regard to the interpretation of drug data. Creates documentation on all projects to ensure continuity and as a resource for future projects.
• Analyzes and interprets medical and pharmacy data and provides recommendations for financial and performance metrics. Collaborates with interdepartmental and cross departmental analysts to ensure prompt delivery of necessary analytics. Identifies and reports to leadership potential process improvement for analytical functions within Pharmacy Department.
• Completes multiple data projects with competing deadlines. Works with team and department leadership to prioritize deliverables and meet reporting deadlines (weekly, monthly, quarterly or yearly.) Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders.
• Performs other duties as assigned.

Qualifications:

Education and Experience:

• Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required. Master's Degree preferred.
• 3 years progressive experience as a Pharmacy Analyst in health insurance, pharmacy benefit management or a consulting firm, or equivalent experience in various aspects of the healthcare industry (e.g., medical/drug claims processing, provider contracting, medical/ drug policy, utilization management, and reimbursement).

Professional Certification(s):

• SAS, Tableau, and/or Python Certification preferred.
• Microsoft Excel Certification preferred.

Technical Skills and Knowledge:

• Intermediate to advanced skills in data extraction and analytical programming languages (Python, R, SQL, Spark), and data visualization tools (Power BI, Dash), and the ability to perform queries and retrieve data from multiple tables and/or sources.
• Intermediate knowledge of a cloud-based analytics platform (Azure databricks).
• Good track record of success with analyzing clinical, claims, pharmacy, program and other administrative data.
• Solid knowledge of health insurance products and industry, including trends and drivers of medical or pharmacy drug utilization, cost, and quality, and application of that knowledge to drive strategic decision making.
• Good project management skills.
• Good business acumen.
• Ability to interact with internal and external senior leaders.