Pbm Contracting Jobs in Minnesota (NOW HIRING)

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for.

We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued.

In this position, the Pharmacy Analytics Analyst will evaluate and assess pharmacy data to identify trends and opportunities. This specialized pharmacy healthcare analyst role will possess an understanding of pharmacy and medical claims, pharmacy drug pricing, pharma rebates, drug life-cycle, drug pipeline, and PBM contracting elements. The Pharmacy analyst will determine requirements, create standards and/or define metrics to ensure complete and accurate pharmacy reporting. The analyst will provide Insight and recommendations using quantitative analysis and/or statistical analysis coupled with explanatory and predictive modeling to drive focused decision making. The ideal candidate will possess strong analytical skills, and an understanding of the healthcare and PBM landscape. 

Key Accountabilities

• Data Mining and Report Development 
  
  • Leverage analytical tools in the collection, analysis and reporting of pharmacy data, pharmacy trends, and key performance metrics

• Data Analysis and Report Development
  • Utilize statistical methods and data analysis tools to identify trends in pharmacy claims and other pharmacy data and key performance indicators
  • Demonstrate knowledge of components of trend for pharmacy and medical reporting and turn into actionable insights
  • Create and present comprehensive reports that summarize findings, highlight trends and provide actionable insights to stakeholders

• Documentation
  • Document report development and data processes into formal process and procedure artifacts

• Continuous Improvement & Training and Development
  • Stay informed about industry trends, emerging technologies, and best practices in pharmacy healthcare to drive continuous improvement within the pharmacy trend management processes
  • Provide training and support to team members on data analysis tools and methodologies, fostering a culture of learning and professional development

• Cross Department Collaboration
  • Facilitate collaboration with various stakeholders including, clinical, financial, actuary, provider, network, and operations

Specific types of experience or skills required:    

• Technical Skills: Proficiency in data analysis tools and software (e.g. Microsoft Excel, Tableau, SQL, SAS or similar).
• Strong analytical skills with the ability to interpret complex data sets and generate actionable insights.
• Proficient in report development and automation tools. Demonstrated ability to created comprehensive, visually engaging reports that effectively communicate data insights.

Required Qualifications

• A minimum of 5 years of experience in pharmacy healthcare analytics, with a focus on data analysis or trend management.

Specific types of experience or skills required

• Technical Skills: Proficiency in data analysis tools and software (e.g. Microsoft Excel, Tableau, SQL, SAS or similar).
• Strong analytical skills with the ability to interpret complex data sets and generate actionable insights.
• Proficient in report development and automation tools. Demonstrated ability to created comprehensive, visually engaging reports that effectively communicate data insights.

This position is an Office role, which requires an employee to work onsite, on average, 3 days per week. We are open to candidates located near one of the following office locations: Minnetonka, MN, or Madison, WI.

The full salary grade for this position is $78,700 - $134,900. While the full salary grade is provided, the typical hiring salary range for this role is expected to be between $78,700 - $118,020. Annual salary range placement will depend on a variety of factors including, but not limited to, education, work experience, applicable certifications and/or licensure, the position's scope and responsibility, internal pay equity and external market salary data. In addition to compensation, Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

The compensation and benefits information is provided as of the date of this posting. Medica’s compensation and benefits are subject to change at any time, with or without notice, subject to applicable law.

Eligibility to work in the US: Medica does not offer work visa sponsorship for this role. All candidates must be legally authorized to work in the United States at the time of application. Employment is contingent on verification of identity and eligibility to work in the United States.

We are an Equal Opportunity employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.