Milliman Care Guidelines
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Pharmacy Benefits Analyst (Chicago-Milwaukee Health)
at Milliman Care Guidelines
Pharmacy benefits is one of the fastest-growing segments of the healthcare industry, and pharmacy benefits management (PBM) arrangements can be extremely complicated. A pharmacy benefits analyst at Milliman can help support clients by helping them navigate the complex industry and provide data-driven solutions that can improve or lower the cost of care.
DUTIES, RESPONSIBILITIES, AND OBJECTIVES
- 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
- Manage client relationships, projects, assignments, presentations, and deliverables
- Be able to work independently, but also actively lead teams utilizing pharmacy data expertise on various projects
BEHAVIORS AND COMPETENCIES THAT SUPPORT SUCCESS IN 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
REQUIRED KNOWLEDGE, SKILLS, AND EXPERIENCE
- Strong business software capabilities, especially with Microsoft office tools (Excel) and data analysis technologies (SAS/SQL).
- Extensive knowledge of pharmacy claims reimbursement (ex. WAC, AWP, discounts, rebates, etc.)
- Experience with handling raw pharmacy claims data (ex. NCPDP D.0 format)
- Experience creating models and reports focused on opportunities for formulary management, prior authorizations, drug pricing, etc..
- A minimum five years of experience in the pharmacy benefits industry (ex. PBM, health plan, etc.)
EDUCATION, LICENSE, AND/OR CERTIFICATION REQUIREMENTS
- Bachelor’s degree
- Pharmacy technician certification (CPhT) optional
Application: Candidates who upload a resume and cover letter will be given first consideration.
Salary: The salary for this position is commensurate with experience and skills.
Location: This position is for the Chicago-Milwaukee (combined) Health Practice. Employees have the option to work out of the Chicago or Milwaukee office. All aspects of this position are identical between both locations (types of projects, organizational structure, exam program, bonus program, etc.). Our office locations work together as one team with the only difference being physical location.
Applicants must be presently authorized to work in the United States. Milliman will not sponsor applicants for this position for the following work visas/statuses: F-1 STEM OPT, H-1B, J-1, TN, O-1, L-1, or E-1/2.