Functional Analyst II - Pharmacy (Remote)

CareFirst•Baltimore, MD

1d•Remote

About The Position

The Pharmacy Analyst Functional II supports pharmacy financial performance and contract compliance through analytics, monitoring, reconciliation, and validation of financial guarantees, invoices, and payments. This role ensures accurate documentation, supports audit and compliance activities. The analyst partners with Finance, Account Management, analytics teams and other key stakeholders to deliver accurate reporting, resolve issues and identify insights that improve pharmacy financial performance.

Requirements

Bachelor's Degree in Business Administration or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
2 years experience as a Functional Analyst OR 4 years experience in (level 2 or above) operational role.
Highly proficient in Microsoft Office and similar applications.
Ability to create graphics and report to non-technical audiences.
Self-starter and ability to collaborate in a team environment.
Excellent communication skills both written and verbal.
Ability to synthesize large complex data and analysis into actionable insights.
Apply strong critical thinking and problem-solving skills to analyze issues, data and identify solutions.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Must be eligible to work in the U.S. without Sponsorship

Nice To Haves

7+ years experience in an analytical role preferred.
Experience in pharmacy within one or more of the following areas: PBM, health care financials, medical rebates, Medicare, Medicaid and/or Commercial pharmacy operations.

Responsibilities

Partner with cross-functional teams to support audit activities and issue resolution while ensuring accuracy and compliance with organizational standards.
Analyze pharmacy financial, contract, and operational data to identify trends, variances, risks, and improvement opportunities.
Monitor, reconcile, and validate financial guarantees and performance measures for Plan-to-PBM and client arrangements.
Support calculation, validation, reconciliation, and documentation of pharmacy-related payments, including rebates, network discounts, medical rebates, and other guarantee components.
Validate invoices and payment activity in coordination with Finance and cross-functional partners to ensure accuracy, timeliness, and compliance.
Prepare reporting, analysis, and documentation for audits, compliance reviews, root cause analysis, and stakeholder requests.
Partner with analytics teams to develop insights and recommendations that improve visibility into pharmacy financial performance and contract outcomes.
Support Account Management, Pharmacy leadership and other stakeholder with reporting, analysis, issue resolution and ad-hoc requests.