Medicare Part D Operations Analyst Jobs (NOW HIRING)

About Us
ADVI Health: Expert Advice. Clear Vision.
Since 2013, clients have sought ADVI Health's expert advice, informed by data and guided by a clear vision of the complex intersection of life sciences/healthcare innovation, economics, policy, and patient impact. Our aim is to be the leading and most knowledgeable go-to-market access and commercialization partner for life sciences and healthcare innovators, worldwide.
We are a collaborative team of consultants and advisors, all of whom are veterans of top healthcare and life sciences organizations, the federal government, state government, top consultants, nonprofits, commercial payers, or data and analytics companies. Our work cuts through complexity across asset, franchise, corporate, and executive level strategy, shapes markets, and enables therapies to launch faster, smarter, and at scale in multiple therapeutic areas, lifecycle stages, and areas of the world. Our global client roster includes biopharma manufacturers, MedTech, precision medicine diagnostics and tools companies, and cancer provider and patient organizations, from the C-suite down and across the product lifecycle . We solve complicated problems with data-informed commercialization, market access, and policy expertise. Based in Washington, DC and Austin, TX, the company delivers insight- and data-informed advice and vision for leaders in healthcare business and policy. ADVI offers a comprehensive perspective by integrating business, policy, and science to find creative solutions through data, learned insight, and compelling strategy to help clients make decisions across all healthcare segments.
ADVI is at the forefront of healthcare delivery transformation, payment reform, public and private payer coverage, and healthcare merger and acquisition deal flow within the US and abroad. Learn more... visit us at www.advi.com
*Candidates must be legally authorized to work full time in the United States at the time of their hire. ADVI does not offer employment sponsorships now or in the future.
Join Us
ADVI Health is seeking a Data Scientist to join our Strategic Analytics, Value & Economics Team. In this role, you'll apply real-world data and advanced healthcare analytics to answer complex questions that influence how innovative therapies are evaluated, valued, reimbursed, and accessed.
You'll work alongside experienced consultants, health economists, policy experts, and market access strategists to develop analyses that bring clarity to complex healthcare questions. In this role, you will leverage advanced statistical modeling, machine learning, and big data to analyze healthcare utilization, optimize drug formulary strategies, and predict spending trends. You will transform Medicare Part D and Real-World Evidence (RWE) datasets into actionable insights that directly influence market access, pricing, and health economics outcomes research (HEOR) strategies.
Core Responsibilities:

• Advanced Analytics & Modeling: Develop, validate, and deploy predictive and statistical models in Python or R to forecast prescription drug spending, patient utilization, and market shifts.
• Medicare Part D Optimization: Analyze Prescription Drug Event (PDE) claims, formulary tier structures, and beneficiary out-of-pocket costs to optimize plan performance and market positioning.
• Large-Scale Data Engineering: Query, clean, and synthesize massive, unstructured administrative healthcare datasets, including public and restricted CMS data files, using SQL and cloud data platforms.
• Fraud & Risk Assessment: Build data-mining algorithms to identify market anomalies, track attrition rates, and detect potential fraud, waste, or abuse.
• Cross-Functional Collaboration: Partner closely with market access professionals, health economists, and consulting associates to translate analytical findings into strategic reports for pharmaceutical and precision medicine clients.
• Regulatory Alignment: Continuously adapt existing data models to reflect changing federal healthcare regulations, benefit redesigns, and modern payment structures.

This is an opportunity to work at the intersection of data science, real-world evidence, health economics, and market access-with your work contributing directly to client recommendations and strategic decision-making.
Duties Include:

• Design and conduct analyses using Medicare, Medicaid, commercial claims, pharmacy, EHR, and other real-world healthcare data.
• Work extensively with CMS data, including PDE data, CCW, VRDC, and other Medicare and Medicaid data sources.
• Develop and maintain analytical programs using SAS, with additional experience in SQL, R, or Python valued.
• Contribute to observational research and real-world evidence studies supporting life sciences clients.
• Partner with consultants and subject-matter experts to translate analytical findings into clear, actionable insights.
• Support the development of client-facing presentations, reports, exhibits, and other deliverables.
• Communicate complex analytical concepts and findings to both technical and non-technical audiences.
• Apply rigorous programming, documentation, validation, and quality assurance practices to ensure analytical integrity.
• Contribute to projects spanning market access, reimbursement, pricing, healthcare policy, and value strategy.

Requirements

• Bachelor's degree in Computer Science, Data Science, Biostatistics, Epidemiology, Public Health, Health Economics, or another quantitative discipline.
• Hands-on experience working with Medicare PDE data is required.
• Professional experience using SAS.
• Experience in healthcare analytics, HEOR, RWE, observational research, or a related field.
• Experience working with healthcare claims and pharmacy data.
• Familiarity with Medicare and Medicaid data, reimbursement, and healthcare policy.
• Experience with CMS Chronic Conditions Warehouse (CCW), Virtual Research Data Center (VRDC), T-MSIS, or similar healthcare data environments.
• Strong analytical, problem-solving, and communication skills.
• Ability to work collaboratively in a consulting environment and manage multiple project priorities.

Location
Candidates can be based anywhere in the U.S., with a preference for those operating in the Eastern or Central Standard Time Zone. Candidates based in Washington, DC or Austin, TX, will have the option of hybrid work arrangements.
Compensation and Benefits
The salary range is $90,000-$140,000 annual base salary plus bonus plan. Exceptionally qualified candidates will be evaluated according to experience levels. Please include your salary requirements with your application if they exceed the posted range. This range reflects ADVI's current expectations for the role. Actual compensation may vary and will be determined based on a number of factors including, but not limited to, job related skills, experience, education, internal equity, and market considerations.
The base salary range does not include bonuses, potential commission or other incentive compensation, which may be available as part of the total rewards package. Additional details regarding compensation philosophy and benefits will be shared by the recruiter during the interview process.
ADVI offers an outstanding benefits package, including the following:
• Medical, dental, and vision
• 8 paid holidays, including one ADVI Anniversary Day per calendar year
• 401(k) retirement contribution match, with a safe harbor company contribution
• Health Reimbursement Account
• Life and short-term and long-term disability insurance
• Paid vacation and sick leave
Diversity Statement
ADVI's commitment to diversity, equity, inclusion, and collaboration is key to building extraordinary teams. We hire people with exceptional talents, abilities, and potential, then build an environment where you can become the best version of yourself.
Our Vision
To be the leading and most knowledgeable go-to-market access and commercialization partner for life sciences and healthcare innovators worldwide.
Our Mission
To provide life science and healthcare innovators the benefit of our team's wisdom, empathy, and creativity that, through data-informed strategy, generates evidence to optimize outcomes and, through tech-enabled access solutions, creates opportunities and expands care.
Our Values
Act with Integrity
Strive for Excellence
Make an Impact
Think smart, Stay curious
Celebrate the Journey, not just the results
We look forward to hearing from you!
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