Pharmacy Medical Informatics Analyst, Principal

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Job description

Your Role

The Cost of Health Care Actuarial team is responsible for supporting the Pharmacy Reimagined strategy in addition to traditional actuarial functions of claim reserves and cost trends. The Pharmacy Medical Informaticist, Principal will report to the Senior Director, Cost of Health Care Actuarial. In this role you will support the Pharmacy Team's strategic objectives in contract negotiations, pricing for self-funded employer groups, formulary changes, product development, and initiative evaluation.

Your Work

In this role, you will:

Use deep understanding of underlying business requirements to conceptualize and develop analytical systems that meet important business needs

Design and develop these systems so that they can be used by lower-level analysts thereby promoting company-wide efficiencies

Coordinate activities with other internal departments to maximize overall efficiency and resolve conflicts

Communicate project status, progress, and outcomes to executive management

Fulfill a leadership role in the critical review and ongoing development of data management and analytical systems for strategically important enterprise-wide analysis and reporting

Support vendor financial contract performance evaluation, forecast and negotiation (e.g. rebates, network contracts)

Support development of budget/trend impact models and formulary strategy models for high impact existing and pipeline drugs

Provide Rx data support and participate in product governance /value assessment committee on Rx benefit and formulary strategy

Support ASO product strategy evaluation and coordinate with UW and Actuarial Trend teams as needed

Support RxCare strategic initiatives evaluation as needed

Your Knowledge and Experience

Requires an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research or business, or BA/BS with demonstrated equivalent work experience

Requires SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent

Requires at least 10 years of prior relevant experience

Requires at least 5 years of experience in Health Care (managed care, academic, or gov't payer)

Requires experience at a Pharmacy Benefit Manager (PBM)

Pay Range:

The pay range for this role is: $ (phone number removed) to $ (phone number removed) for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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