Analyst, Payor Operations and Solutions

Walgreens•Deerfield, IL

2d•$65,000 - $113,750

About The Position

Analyzes data to support decisions on individual proposals and contracts related to pharmacy programs. Analysis may include new product pricing, product portfolios, profitability of new opportunities with current and new clients, regulatory changes, capital, and profit margins. Assists in developing, implementing, and monitoring strategies and tools to ensure third-party pharmacy programs comply with contractual terms and conditions for designated products or services.

Requirements

Bachelor's degree, or a high school diploma/GED and at least 3 years of healthcare industry experience.
Experience analyzing and reporting data to identify issues, trends, or exceptions and drive improvement and solutions.
Experience prioritizing, organizing, and tracking details and meeting deadlines across multiple projects with varying completion dates.
Experience providing customer service to internal and external customers while meeting service quality standards.
Intermediate Microsoft Excel skills.
Intermediate Microsoft PowerPoint skills.
Intermediate Microsoft Word skills.
Understanding of project management and lean methodologies.
Willingness to travel up to 10% for business, within and outside the state.

Nice To Haves

Advanced Microsoft Excel skills.
At least 2 years of experience implementing contracted third-party programs in the healthcare industry.
At least 2 years of experience administering healthcare contracts.
At least 2 years of payor and facility credentialing experience.
At least 2 years of medical reimbursement or fee schedule maintenance experience.
Infusion, specialty pharmacy, retail clinic, and/or pharmacy technician experience.
Experience using Walgreens proprietary systems such as AS400, SIMS, POS, or IC+.
At least 2 years of experience working in retail pharmacy operations.
Experience providing customer service to internal and external customers, meeting quality standards, and evaluating customer satisfaction.

Responsibilities

Create and maintain reports and portals for posting, tracking, and reporting on initiatives, policies and procedures, departmental forms, and contracted policies and information.
Assist with implementation of new third-party plans and updates to existing plans; review and approve administrative paperwork before routing implementation information to appropriate internal departments.
Track and resolve post-implementation issues related to contracts and pricing.
Review contracts and provide management with feedback on opportunities and immediate needs related to contracted terms and programs; resolve contract compliance issues and track financial impact.
Escalate issues as necessary.
Assist in developing financial models for management decisions concerning new product development, product portfolio analysis, opportunity profitability, capital investments, revenue models, profit margins, and regulatory changes.
Present findings to management and make recommendations that are market competitive and align with Walgreens' strategy.
Perform ad hoc analysis and forecasting for internal management and external customers.
Assist in developing standard operating procedures and provide guidance on Contracts & Pricing processes, procedures, and functionality.
Develop and maintain client relationships by providing services that meet client needs while monitoring operational policies and procedures.
Report client-service gaps and business issues involving non-compliance to management.
Assist field personnel and management in resolving member issues.